Healthcare Provider Details

I. General information

NPI: 1235231812
Provider Name (Legal Business Name): MARILYN FUCHS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N GLEBE RD STE 303
ARLINGTON VA
22207-3558
US

IV. Provider business mailing address

5405 CAROLINA PL NW
WASHINGTON DC
20016-2525
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-1290
  • Fax: 703-841-1315
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810001370
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: