Provider Demographics
NPI:1912455056
Name:NEYLAND, MARY KATHLEEN HIGGINS (PHD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHLEEN HIGGINS
Last Name:NEYLAND
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 1:6026 MADISON OVERLOOK CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3651
Mailing Address - Country:US
Mailing Address - Phone:703-457-6545
Mailing Address - Fax:877-706-1876
Practice Address - Street 1:6026 MADISON OVERLOOK CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3651
Practice Address - Country:US
Practice Address - Phone:703-457-6545
Practice Address - Fax:877-706-1876
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005795103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical