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NPI Code Detail

MEDICARE: ELIZABETH DILLARD M.A.

MEDICARE: ELIZABETH DILLARD M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0701011943VA

General Provider Information

NPI Number : 1467825364
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH DILLARD M.A.
Provider Business Mailing Address
First Line : 615 ELSINORE PL FL 3
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1459
Country : US
Telephone Number : 833-510-4357
Fax Number : 866-460-2997
Provider Business Practice Location Address
First Line : 4140 CROSSINGS CT STE 101-103
Second Line :
City : PRINCE GEORGE
State : VA
Zip : 23875-1538
Country : US
Telephone Number : 804-408-4806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2015
Last Update Date : 11/14/2022

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