Provider Demographics
NPI:1912360835
Name:BRESLIN, CAROLYN WINN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:WINN
Last Name:BRESLIN
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 1:7910 WOODMONT AVE
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3002
Mailing Address - Country:US
Mailing Address - Phone:202-909-6420
Mailing Address - Fax:
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 1101
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3002
Practice Address - Country:US
Practice Address - Phone:202-909-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05017103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist