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NPI Code Detail

MEDICARE: MS. ELLEN ARLEDGE MSW

MEDICARE: MS. ELLEN ARLEDGE MSW
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
11041C0700XClinical Social Worker0904002341VA

General Provider Information

NPI Number : 1710085683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN ARLEDGE MSW
Provider Business Mailing Address
First Line : 3635 MANASSAS DR
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4031
Country : US
Telephone Number : 540-774-4686
Fax Number :
Provider Business Practice Location Address
First Line : 3635 MANASSAS DR
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4031
Country : US
Telephone Number : 540-774-4686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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