Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | E026044 | VA |
NPI | 1003255340 |
---|---|
Provider Name | Miss Elizabeth Anderson |
First Address | North Chesterfield, VA 23224-5643 |
Second Address | Louisville, KY 40218-3836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 08/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E026044 | (05) | VA |