Healthcare Provider Details

I. General information

NPI: 1851666895
Provider Name (Legal Business Name): TARYN WALKER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 HERITAGE WAY NE STE 302
LEESBURG VA
20176-4544
US

IV. Provider business mailing address

8901 NEW HAMPSHIRE AVE
SILVER SPRING MD
20903-3611
US

V. Phone/Fax

Practice location:
  • Phone: 703-771-5166
  • Fax: 703-777-0170
Mailing address:
  • Phone: 301-422-5443
  • Fax: 301-422-5416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: