Healthcare Provider Details

I. General information

NPI: 1124589288
Provider Name (Legal Business Name): GEORGETOWN NEUROPSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 WISCONSIN AVE NW STE 307
WASHINGTON DC
20007-4104
US

IV. Provider business mailing address

2233 WISCONSIN AVE NW STE 307
WASHINGTON DC
20007-4104
US

V. Phone/Fax

Practice location:
  • Phone: 202-342-2233
  • Fax:
Mailing address:
  • Phone: 202-342-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTORIA NOYES STARBUCK
Title or Position: OWNER
Credential: PH.D.
Phone: 202-343-2233