Provider Demographics
NPI:1780975060
Name:BANH, MY K (PHD)
Entity type:Individual
Prefix:
First Name:MY
Middle Name:K
Last Name:BANH
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 1:3800 RESERVOIR RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2113
Mailing Address - Country:US
Mailing Address - Phone:202-944-5400
Mailing Address - Fax:202-944-5402
Practice Address - Street 1:2000 15TH ST N
Practice Address - Street 2:SUITE 600
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2683
Practice Address - Country:US
Practice Address - Phone:703-558-1400
Practice Address - Fax:703-558-1445
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000713103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist