Provider Demographics
NPI:1396331914
Name:CHOURAESHKENAZI, MONIQUE MARIE (PHD, PSYD, MSCP)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:MARIE
Last Name:CHOURAESHKENAZI
Suffix:
Gender:F
Credentials:PHD, PSYD, MSCP
Other - Prefix:DR
Other - First Name:MONIQUE
Other - Middle Name:MARIE
Other - Last Name:CHOURAESHKENAZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, PSYD, MSCP
Mailing Address - Street 1:8609 WESTWOOD CENTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:TYSONS CORNER
Mailing Address - State:VA
Mailing Address - Zip Code:22182-7525
Mailing Address - Country:US
Mailing Address - Phone:703-646-0730
Mailing Address - Fax:
Practice Address - Street 1:2680 OPITZ BLVD # 220
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6822
Practice Address - Country:US
Practice Address - Phone:703-497-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other