MEDICARE: DR. CAROLYN J. NOEL PSY.D.

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
1	103G00000X	Clinical Neuropsychologist	0810003790	VA

General Provider Information

NPI Number	:	1477677185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN J. NOEL PSY.D.

Provider Business Mailing Address
First Line	:	2200 WILSON BOULEVARD
Second Line	:	SUITE 401
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3397
Country	:	US
Telephone Number	:	703-875-0475
Fax Number	:	703-782-1314

Provider Business Practice Location Address
First Line	:	2200 WILSON BLVD
Second Line	:	SUITE 401
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3397
Country	:	US
Telephone Number	:	703-875-0475
Fax Number	:	703-782-1314

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	11/20/2015

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