=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154137776
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CIARA CAPRARA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2024
-----------------------------------------------------
Last Update Date | 12/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2100 BALTIMORE RD
-----------------------------------------------------
City | ROCKVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20851-1297
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-740-6600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 850 HUNGERFORD DR RM 50
-----------------------------------------------------
City | ROCKVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20850-1718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-740-5640
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | CER-188647-J8N4G5
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------