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NPI Code Detail

MEDICARE: MRS. KATHERINE A TAVES M.A.

MEDICARE: MRS. KATHERINE A TAVES M.A.
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
1103TC0700XClinical Psychologist3960NC
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1699096164
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE A TAVES M.A.
Provider Business Mailing Address
First Line : 133 PARK ST NE
Second Line : SUITE 3B
City : VIENNA
State : VA
Zip : 22180-4666
Country : US
Telephone Number : 571-206-4878
Fax Number :
Provider Business Practice Location Address
First Line : 133 PARK ST NE
Second Line : SUITE 3B
City : VIENNA
State : VA
Zip : 22180-4666
Country : US
Telephone Number : 571-206-4878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2010
Last Update Date : 06/06/2016

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