Provider Demographics
NPI:1952352916
Name:ALFARO, MERCEDES HELENA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:HELENA
Last Name:ALFARO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20122-0640
Mailing Address - Country:US
Mailing Address - Phone:703-879-5130
Mailing Address - Fax:703-635-3681
Practice Address - Street 1:6262 CLAY PIPE CT
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-5620
Practice Address - Country:US
Practice Address - Phone:703-879-5130
Practice Address - Fax:703-635-3681
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003332103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist