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General NPI Number Information
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NPI Number | 1033264643
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Entity Type | Individual
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Provider Name | ANN RAYBURN ANN RAYBURN MA LPC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 313 PARK AVE SUITE 300
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3327
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Country | US
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Telephone | 703-578-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 7129 ALGER RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-2552
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Country | US
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Telephone | 703-698-9210
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701000560
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License Number State | VA
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