Provider Demographics
NPI:1104973759
Name:WEINSTEIN, ROXANA (PHD)
Entity type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:
Last Name:WEINSTEIN
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 1:3045 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4376
Mailing Address - Country:US
Mailing Address - Phone:703-271-8800
Mailing Address - Fax:703-271-8585
Practice Address - Street 1:3045 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4376
Practice Address - Country:US
Practice Address - Phone:703-271-8800
Practice Address - Fax:703-271-8585
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000376103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7714343Medicaid