Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 01654 | MD |
Y | 103G00000X | Clinical Psychologist | 01654 | MD |
Y | 103TC0700X | Clinical Psychologist | 01654 | MD |
N | 103TH0100X | Health Service | 01654 | MD |
NPI | 1366979619 |
---|---|
Provider Name | Dr. Caroline Heyward Sparks |
First Address | Bethesda, MD 20815-7007 |
Second Address | Bethesda, MD 20815-7007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2017 |
Last Update Date | 10/08/2017 |