Provider Demographics
NPI:1679667216
Name:ISENHOWER, REBECCA SUE (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SUE
Last Name:ISENHOWER
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 1:2185 WELLTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:CLEARBROOK
Mailing Address - State:VA
Mailing Address - Zip Code:22624-1657
Mailing Address - Country:US
Mailing Address - Phone:540-667-7605
Mailing Address - Fax:540-662-1311
Practice Address - Street 1:174 COSTELLO DRIVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602
Practice Address - Country:US
Practice Address - Phone:540-662-7007
Practice Address - Fax:540-662-1311
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003609103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist