Provider Demographics
NPI:1518184548
Name:KELLER, BARBARA B (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:B
Last Name:KELLER
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 1:3615 CHAIN BRIDGE RD STE F
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3237
Mailing Address - Country:US
Mailing Address - Phone:703-280-2931
Mailing Address - Fax:
Practice Address - Street 1:3615 CHAIN BRIDGE RD STE F
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3237
Practice Address - Country:US
Practice Address - Phone:703-280-2931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001398103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist