Individual
CARLY LYNNE MOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
302 HICKMAN RD STE 105, CHARLOTTESVILLE, VA 22911-3572
(773) 320-2907
Mailing address
302 HICKMAN RD., SUITE 105, CHARLOTTESVILLE, VA 22911
(773) 320-2907
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005487
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-1710406
TAX ID
—
Enumeration date
02/11/2013
Last updated
07/21/2022
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