Tara Wall Brown is a Psychologist in Fairfax, Virginia. Tara Wall Brown practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Tara Wall Brown is 1982603692. The last update date is 2011-11-10.
Tara Wall Brown's current location address is 8500 Executive Park Ave, Fairfax, Virginia. You can contact this provider via phone number 7036985200 and fax number 7035732351. The mailing address for Tara Wall Brown is 8500 Executive Park Ave, Fairfax, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tara Wall Brown |
|---|---|
| Address | 8500 Executive Park Ave, Fairfax, Virginia |
| Phone Number | 7036985200 |
| Fax Number | 7035732351 |
| Sole Proprietor | N |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1982603692 |
|---|---|
| Provider Enumeration Date | 2005-07-15 |
| Last Updated Date | 2011-11-10 |
Provider Mailing Address Detail
| Address | 8500 Executive Park Ave |
|---|---|
| City | Fairfax |
| State | Virginia (VA) |
| Post Code | 220312225 |
| Phone Number | 7036985200 |
| Fax Number | 7035732351 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 810003400 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 139478 | VA | ANTHEM | |
| 681761 | VA | NCPPO | |
| 735839-000 | VA | MAGELLAN | |
| 81 | VA | CAREFIRST DC | |
| 7513603 | AETNA | ||
| 2160264 | MAMSI |
Post Comment/ Review Below
What is the unique identifier code issued to Tara Wall Brown by the Centers for Medicare & Medicaid Services (CMS)?
The Tara Wall Brown has been assigned the NPI (National Provider Identifier) 1982603692. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Tara Wall Brown?
The Tara Wall Brown is physically situated at 8500 Executive Park Ave, in the city of Fairfax, state of VA, with the postal code 220312225.
What is the Tara Wall Brown's area of specialization and corresponding taxonomy classification?
The Tara Wall Brown's specialty field is Psychologist, and it falls under the taxonomy code 103T00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1982603692 to Tara Wall Brown?
The Tara Wall Brown received its 1982603692 assignment from the Centers for Medicare & Medicaid Services on 2005-07-15.
As of what date were the Tara Wall Brown's details last updated?
The information pertaining to the Tara Wall Brown, including its address, specialty, and other details, was most recently updated on 2011-11-10.