Healthcare Provider Details
I. General information
NPI: 1295284958
Provider Name (Legal Business Name): ARIELLA KAREN GELB MARCUS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2016
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 WILSON BLVD SUITE 401
ARLINGTON VA
22201-3397
US
IV. Provider business mailing address
2200 WILSON BLVD SUITE 401
ARLINGTON VA
22201-3397
US
V. Phone/Fax
- Phone: 703-875-0475
- Fax:
- Phone: 703-875-0475
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 0810005344 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: