Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TARA BANKS WALLACE, PSY.D.
Active Sole ProprietorTARA BANKS WALLACE, PSY.D. is a Child, Clinical Psychologist healthcare provider located in FAIRFAX, Virginia. NPI 1457644585 is currently active in the NPPES registry. Verify at CMS.
Child, Clinical Psychologist · FAIRFAX, VA
Registration Details
- NPI Number
- 1457644585
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 23, 2011 (15.210110147912 yrs)
- Last Updated
- May 23, 2011
- License
-
0810004361 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8626 LEE HWY STE 200FAIRFAX, VA, 220312135Browse VA providers · Browse ZIP 22031
- Phone
- 5713930075
- Primary Specialty
-
Child, Clinical Psychologist
103TC2200X
Other Child, Clinical Psychologist Providers in FAIRFAX, VA
| Name | Credential | NPI |
|---|---|---|
| DR. MICHELLE F EABON | PH.D. | 1770529653 |
| DEBORAH COHEN | PH.D. | 1407052905 |
| DR. EMILY B NICHOLS | PHD | 1275877607 |
| DR. CATHERINE A RATHMAN | PH.D. | 1285970087 |
| JUSTINE SIMPSON | — | 1609201037 |
| EMILY CLAUS | — | 1780097840 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.