Provider Demographics
NPI:1437912318
Name:DUBENDORFF, SARAH JULIANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JULIANNA
Last Name:DUBENDORFF
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 1:1221 KING ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2926
Mailing Address - Country:US
Mailing Address - Phone:571-478-9499
Mailing Address - Fax:
Practice Address - Street 1:1221 KING ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2926
Practice Address - Country:US
Practice Address - Phone:571-478-9499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008368103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical