MEDICARE: DR. MARCIA CHRISTINE KEATING PERKINS PH.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	103TC0700X	Clinical Psychologist	0810003043	VA

General Provider Information

NPI Number	:	1851510226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCIA CHRISTINE KEATING PERKINS PH.D.

Provider Business Mailing Address
First Line	:	46179 WESTLAKE DR
Second Line	:	SUITE 250
City	:	STERLING
State	:	VA
Zip	:	20165-5874
Country	:	US
Telephone Number	:	703-217-7331
Fax Number	:

Provider Business Practice Location Address
First Line	:	46179 WESTLAKE DR
Second Line	:	SUITE 250
City	:	STERLING
State	:	VA
Zip	:	20165-5874
Country	:	US
Telephone Number	:	703-217-7331
Fax Number	:

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	03/07/2017

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