Healthcare Provider Details

I. General information

NPI: 1447891759
Provider Name (Legal Business Name): ERICAGANTS.PH.D.PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 LITTLE FALLS ST STE 212
FALLS CHURCH VA
22046-4323
US

IV. Provider business mailing address

140 LITTLE FALLS ST STE 212
FALLS CHURCH VA
22046-4323
US

V. Phone/Fax

Practice location:
  • Phone: 703-568-2892
  • Fax: 703-536-1775
Mailing address:
  • Phone: 703-568-2892
  • Fax: 703-536-1775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ERICA SARI GANTS
Title or Position: OWNER
Credential: PH.D.
Phone: 703-568-2892