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Individual

EVA CHIRIBOGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
8630 FENTON ST STE 328, SILVER SPRING, MD 20910-3816
(301) 328-1625
Mailing address
8630 FENTON ST STE 328, SILVER SPRING, MD 20910-3816
(301) 328-1625

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
06543
MD
103TC0700X
Clinical Psychologist
0810007358
VA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06543
STATE LICENSE
MD
01
0810007358
STATE LICENSE
VA
Enumeration date
02/10/2017
Last updated
06/25/2021
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