Healthcare Provider Details
I. General information
NPI: 1356841068
Provider Name (Legal Business Name): HAD MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2018
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1320 OLD CHAIN BRIDGE RD STE 185
MC LEAN VA
22101-3945
US
IV. Provider business mailing address
1320 OLD CHAIN BRIDGE RD STE 185
MC LEAN VA
22101-3945
US
V. Phone/Fax
- Phone: 703-942-8110
- Fax: 703-942-8042
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANA
ANZOLA
Title or Position: AUDIOLOGIST / OWNER
Credential: CCC-A, FAAA, ABA
Phone: 703-942-8110