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General NPI Number Information
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NPI Number | 1952756595
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Entity Type | Individual
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Provider Name | DIANA ANDERSON TOWNSEND M.S.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 21576 IREDELL TER
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City | BROADLANDS
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State | VA
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Zip | 20148-5033
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Country | US
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Telephone | 510-738-7709
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Fax |
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Provider Business Mailing Address
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Address Line | 9508 QUAIL POINTE LN
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-3317
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Country | US
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Telephone | 571-334-2375
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1235381633
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License Number State | VA
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