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Contact Information

MARY E WARREN, PHD
4348 ELECTRIC RD
ROANOKE, VA24018-0720
 Phone: 540-769-0976
 Fax: 540-857-5385
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARY E WARREN · (Female)

NPI # 1902904477
Status Active
Credentials PHD
Entity Individual
Enumeration date 09/20/2006
Last updated 04/11/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • SC License # 633
  • VA License # 0810008462
  • SC Medicaid PS0409
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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