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NPI Code Detail

MEDICARE: MARIA CHRISTINA BARONGAN PHD

MEDICARE:   MARIA CHRISTINA BARONGAN  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist0810002874VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10810002874OTHERVASTATE LICENSE

General Provider Information

NPI Number : 1326387689
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA CHRISTINA BARONGAN PHD
Provider Business Mailing Address
First Line : 75 STONE RIDGE LN
Second Line :
City : DALEVILLE
State : VA
Zip : 24083-3085
Country : US
Telephone Number : 540-463-6932
Fax Number :
Provider Business Practice Location Address
First Line : 204 W WASHINGTON ST
Second Line : DAVIS RESIDENCE HALL
City : LEXINGTON
State : VA
Zip : 24450-2116
Country : US
Telephone Number : 540-458-8590
Fax Number : 540-458-8989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2013
Last Update Date : 02/06/2013

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Directions to “ MARIA CHRISTINA BARONGAN PHD” Practice Location

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