Healthcare Provider Details

I. General information

NPI: 1245359843
Provider Name (Legal Business Name): CAROLYN WURM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 BUNKER HILL RD NE
WASHINGTON DC
20017-3026
US

IV. Provider business mailing address

1914 35TH PL NW
WASHINGTON DC
20007-2201
US

V. Phone/Fax

Practice location:
  • Phone: 202-635-6178
  • Fax:
Mailing address:
  • Phone: 202-635-6178
  • Fax: 202-636-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY582
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: