NPI 1255490439 · live from the CMS NPI Registry
Nida Ittayem Amal, Psy.D.
Psychologist, Clinical in Vienna, VA. National Provider Identifier 1255490439, active.
NPI record
| NPI | 1255490439 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 133 Park St Ne, Vienna, VA 22180 |
| Practice phone | 703-281-2657 |
| Enumerated | December 6, 2006 |
| Last updated | January 11, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 0810006405 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.