Individual
DR. KAREN KINGSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
22563 FOREST MANOR DR, ASHBURN, VA 20148-6900
(703) 723-9404
(703) 723-9404
Mailing address
22563 FOREST MANOR DR, ASHBURN, VA 20148-6900
(703) 723-9404
(703) 723-9404
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001562
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144360157
UNDER LLC TAX-ID
VA
Enumeration date
07/12/2012
Last updated
07/12/2012
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