Healthcare Provider Details

I. General information

NPI: 1720598428
Provider Name (Legal Business Name): KATHRYN L. CAMPANA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN L. CAMPANA-SCHERER PH.D.

II. Dates (important events)

Enumeration Date: 10/07/2017
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

10875 BUCKNELL DR
SILVER SPRING MD
20902-4325
US

V. Phone/Fax

Practice location:
  • Phone: 202-681-8681
  • Fax:
Mailing address:
  • Phone: 804-314-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000751
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: