Brown, Tara Wall
Brown, Tara Wall is an individual health care provider with primary practice located at 8500 Executive Park Ave Suite 200, Fairfax VA 22031-2225. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Brown, Tara Wall can be contacted via phone (703) 698-5200.Contact Information
Primary practice address
8500 Executive Park Ave Suite 200
Fairfax VA 22031-2225
Phone: (703) 698-5200
Fax: (703) 573-2351
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 0810003400 | Virginia |
Profile Details
| NPI number | 1982603692 |
|---|---|
| LBN Legal business name | Brown, Tara Wall |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Nov 10th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982603692 | NPPES |
| Virginia | Other | 139478 | ANTHEM |
| Virginia | Other | 681761 | ANTHEM |
| Virginia | Other | 735839-000 | ANTHEM |
| Virginia | Other | 0081 | ANTHEM |
| Virginia | Other | 7513603 | ANTHEM |
| Virginia | Other | 2160264 | ANTHEM |
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