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General NPI Number Information
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NPI Number | 1740728062
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Entity Type | Organization
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Legal Business Name | CAROLINE BA, P.C.
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1635 N GEORGE MASON DR SUITE 185
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 202-643-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 N GEORGE MASON DR SUITE 185
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 202-643-6463
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROLINE BA
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Credential |
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Telephone | 202-643-6463
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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 | 0810005508
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License Number State | VA
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