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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MATTHEW STUART BROUDY, PHD

Active

MATTHEW STUART BROUDY, PHD is a Clinical Psychologist healthcare provider located in LAKE RIDGE, Virginia. NPI 1649348145 is currently active in the NPPES registry. Verify at CMS.

Clinical Psychologist · LAKE RIDGE, VA

Registration Details

NPI Number
1649348145
Provider Type
Individual
Gender
Male
NPI Issued
Dec 1, 2006 (19.746536571958 yrs)
Last Updated
Jul 8, 2007
License
0810003712 (VA)

Practice Information

Address
2239F TACKETTS MILL DRIVE
LAKE RIDGE, VA, 22192
Browse VA providers · Browse ZIP 22192
Phone
7034900336
Fax
7034904525
Primary Specialty
Clinical Psychologist
103TC0700X

Other Clinical Psychologist Providers in LAKE RIDGE, VA

Name Credential NPI
KIMBERLY STRAND PHD 1306931126
STEPHANIE FELLENBERG PSYD 1447348198
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.