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1699916288
ELLEN G ANDERSON
HERNDON, VA
NPI
1699916288
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ LISAC0296)
Enumeration Date
2009-03-12
Last Update Date
2009-03-12
Business Address
-- ELLEN G ANDERSON LISAC
457 CARLISLE DR
HERNDON, VA 20170-4819
Phone number: 703-464-5122
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Mailing Address
-- ELLEN G ANDERSON LISAC
457 CARLISLE DR
HERNDON, VA 20170-4819
Phone number: 703-464-5122
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