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General NPI Number Information
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NPI Number | 1033486600
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Entity Type | Individual
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Provider Name | CHRISTINE GOLDEN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/25/2011
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 1483 CHAIN BRIDGE RD STE 301
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City | MC LEAN
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State | VA
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Zip | 22101-5703
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Country | US
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Telephone | 571-234-1057
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 TROMBONE CT
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City | VIENNA
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State | VA
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Zip | 22182-1644
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Country | US
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Telephone | 571-234-1057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6574
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 04996
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 0810004518
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License Number State | VA
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