Provider Demographics
NPI:1720264625
Name:STERN, ROSALIND GRUNSTEIN (EDS)
Entity Type:Individual
Prefix:MS
First Name:ROSALIND
Middle Name:GRUNSTEIN
Last Name:STERN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE#303
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5724
Mailing Address - Country:US
Mailing Address - Phone:703-848-9009
Mailing Address - Fax:
Practice Address - Street 1:1489 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE#303
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5724
Practice Address - Country:US
Practice Address - Phone:703-848-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0803000223103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool