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General NPI Number Information
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NPI Number | 1225158785
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Entity Type | Individual
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Provider Name | CARLA LYNN MESSENGER PH. D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10372 DEMOCRACY LN
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City | FAIRFAX
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State | VA
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Zip | 22030-2522
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Country | US
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Telephone | 703-591-2551
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Fax | 703-591-2563
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Provider Business Mailing Address
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Address Line | 1020 S BARTON ST UNIT 261
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City | ARLINGTON
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State | VA
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Zip | 22204-4837
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Country | US
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Telephone | 703-597-7577
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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 | 0810003803
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License Number State | VA
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