Provider Demographics
NPI:1326387689
Name:BARONGAN, MARIA CHRISTINA (PHD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISTINA
Last Name:BARONGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 STONE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3085
Mailing Address - Country:US
Mailing Address - Phone:540-463-6932
Mailing Address - Fax:
Practice Address - Street 1:204 W WASHINGTON ST
Practice Address - Street 2:DAVIS RESIDENCE HALL
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2116
Practice Address - Country:US
Practice Address - Phone:540-458-8590
Practice Address - Fax:540-458-8989
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002874103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0810002874OtherSTATE LICENSE