Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 06404 | MD |
N | 103T00000X | Psychologist | 06404 | MD |
Y | 102L00000X | Psychologist | PSY1001443 | DC |
Y | 103T00000X | Psychologist | PSY1001443 | DC |
N | 103G00000X | Clinical Psychologist | 0810006741 | VA |
N | 103TC0700X | Clinical Psychologist | 0810006741 | VA |
NPI | 1003340035 |
---|---|
Provider Name | Dr. Jennifer Lee Bakalar |
First Address | Washington, DC 20036-1761 |
Second Address | Washington, DC 20036-1761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2017 |
Last Update Date | 31/03/2021 |