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NPI Code Detail

MEDICARE: DR. MWENDE MUALUKO PHD

MEDICARE: DR. MWENDE MUALUKO 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
1103TC0700XClinical PsychologistPSY-2167HI
2103TC0700XClinical Psychologist9374624-2501UT
3103TC0700XClinical Psychologist0810005824VA
4103TC0700XClinical PsychologistPY60278819WA

General Provider Information

NPI Number : 1760721856
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MWENDE MUALUKO PHD
Provider Business Mailing Address
First Line : 8305 GREENSBORO DR APT 910
Second Line :
City : MC LEAN
State : VA
Zip : 22102-7377
Country : US
Telephone Number : 404-414-8600
Fax Number :
Provider Business Practice Location Address
First Line : 8280 WILLOW OAKS CORPORATE DR STE 600
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4516
Country : US
Telephone Number : 703-634-4490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2013
Last Update Date : 05/10/2024

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Directions to “ DR. MWENDE MUALUKO PHD” Practice Location

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