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NPI Profile for ELLEN G ANDERSON in HERNDON, VA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1699916288 |
|
| Status | Active | |
| Credentials | LISAC | |
| Entity | Individual | |
| Enumeration date | 03/12/2009 | |
| Last updated | 03/12/2009 - About 17 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ELLEN G ANDERSON
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ELLEN G ANDERSON, LISAC