Provider Demographics
NPI:1780819029
Name:KALUNGA, RICHARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:KALUNGA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12120 CHANCERY STATION CIR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5800
Mailing Address - Country:US
Mailing Address - Phone:703-349-0034
Mailing Address - Fax:703-349-0365
Practice Address - Street 1:2 WISCONSIN CIR
Practice Address - Street 2:SUITE 700
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7003
Practice Address - Country:US
Practice Address - Phone:703-349-0034
Practice Address - Fax:703-349-0365
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03798235Z00000X
VA2202003170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist