Provider Demographics
NPI:1679643746
Name:PIETTE, JEANNE MARIE
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:MARIE
Last Name:PIETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 PAISLEY CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4453
Mailing Address - Country:US
Mailing Address - Phone:312-307-1814
Mailing Address - Fax:
Practice Address - Street 1:4000 ALBEMARLE ST NW
Practice Address - Street 2:SUITE #504
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1851
Practice Address - Country:US
Practice Address - Phone:312-307-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000742103TC0700X
IL071005979103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical