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General NPI Number Information
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NPI Number | 1144360157
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Entity Type | Organization
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Legal Business Name | KAREN KINGSLEY, PH.D.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22563 FOREST MANOR DR
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City | ASHBURN
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State | VA
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Zip | 20148-6900
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Country | US
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Telephone | 703-723-9404
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Fax |
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Provider Business Mailing Address
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Address Line | 22563 FOREST MANOR DR
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City | ASHBURN
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State | VA
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Zip | 20148-6900
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Country | US
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Telephone | 703-723-9404
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KAREN KINGSLEY
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Credential | PH.D.
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Telephone | 703-723-9404
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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 | 0810001562
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License Number State | VA
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