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General NPI Number Information
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NPI Number | 1023384823
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Entity Type | Individual
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Provider Name | ELLEN WEBER LIBBY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 1231 POTOMAC ST NW
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City | WASHINGTON
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State | DC
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Zip | 20007-3230
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Country | US
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Telephone | 202-333-4250
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Fax |
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Provider Business Mailing Address
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Address Line | 3309 HARNESS CREEK RD
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1617
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Country | US
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Telephone | 410-990-0214
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Fax | 410-990-0215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1010
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License Number State | DC
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