Provider Demographics
NPI:1588015036
Name:BA, CAROLINE (PSYD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1635 N GEORGE MASON DR STE 185
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3633
Mailing Address - Country:US
Mailing Address - Phone:202-643-6463
Mailing Address - Fax:
Practice Address - Street 1:1635 N GEORGE MASON DR STE 185
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3633
Practice Address - Country:US
Practice Address - Phone:202-643-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist