Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 6574 | OH |
N | 103TC0700X | Clinical Psychologist | 6574 | OH |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 04996 | MD |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 0810004518 | VA |
NPI | 1033486600 |
---|---|
Provider Name | Dr. Christine Golden |
First Address | Vienna, VA 22182-1644 |
Second Address | Mc Lean, VA 22101-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2011 |
Last Update Date | 16/05/2012 |