Provider Demographics
NPI:1124114236
Name:RUPATELIA, SONYA P (PSYD)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:P
Last Name:RUPATELIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20925 PROFESSIONAL PLZ
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3403
Mailing Address - Country:US
Mailing Address - Phone:703-858-9841
Mailing Address - Fax:703-858-9697
Practice Address - Street 1:20925 PROFESSIONAL PLZ
Practice Address - Street 2:SUITE 230
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3403
Practice Address - Country:US
Practice Address - Phone:703-858-9841
Practice Address - Fax:703-858-9697
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003587103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical