Tara Banks Wallace, PSYD in Fairfax, VA

Tara Banks Wallace, PSYD is a Psychologist - Clinical Child & Adolescent based in Fairfax, Virginia. Tara Banks Wallace is licensed to practice in Virginia (license number 0810004361) and her current practice location is 8626 Lee Hwy Ste 200, Fairfax, Virginia. She can be reached at her office (for appointments etc.) via phone at (571) 393-0075.

NPI number for Tara Banks Wallace is 1457644585 and her current mailing address is 12043 Elliots Oak Pl, Bristow, Virginia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1457644585.

Contact Information

	Tara Banks Wallace, PSYD
	8626 Lee Hwy Ste 200, Fairfax, VA 22031-2135
	(571) 393-0075
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Tara Banks Wallace
Gender	Female
Speciality	Psychologist - Clinical Child & Adolescent
Location	8626 Lee Hwy Ste 200, Fairfax, Virginia
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1457644585
Provider Enumeration Date: 05/23/2011
Last Update Date: 05/23/2011

Medical Identifiers

Medical identifiers for Tara Banks Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457644585	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC2200X	Psychologist - Clinical Child & Adolescent	0810004361 (Virginia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tara Banks Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Tara Banks Wallace, PSYD 12043 Elliots Oak Pl, Bristow, VA 20136-1265 Ph: () -	Tara Banks Wallace, PSYD 8626 Lee Hwy Ste 200, Fairfax, VA 22031-2135 Ph: (571) 393-0075

Reviews and Comments

Psychologist in Fairfax, VA

Katherine Nethercote, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 571-423-4900
Adrienne Konstantin, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3925 Blenheim Blvd Ste 53a, Fairfax, VA 22030 Phone: 703-972-2388
Dr. Jennie Lynn Crim, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10560 Main St Ste 507, Fairfax, VA 22030 Phone: 703-691-1326 Fax: 703-691-3553
Dr. Diane Marie Hoekstra, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10721 Main St Ste 2350, Fairfax, VA 22030 Phone: 703-591-5912 Fax: 703-581-7210
Frances Jillian Priesmeyer, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 703-619-4859
Kathleen Racz Baker, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 703-899-4061
Jennie Song, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8270 Willow Oaks Corporate Dr, Fairfax, VA 22031 Phone: 571-423-4250

Tara Banks Wallace, PSYD - Psychologist in Fairfax, VA