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NPI Code Detail

MEDICARE: MRS. GABRIELLE L ANDERSON LMFT

MEDICARE:  MRS. GABRIELLE L ANDERSON  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0717001076VA

General Provider Information

NPI Number : 1578610184
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GABRIELLE L ANDERSON LMFT
Provider Business Mailing Address
First Line : 19415 DEERFIELD AVE
Second Line : #307
City : LANSDOWNE
State : VA
Zip : 20176-8452
Country : US
Telephone Number : 703-350-1346
Fax Number :
Provider Business Practice Location Address
First Line : 19415 DEERFIELD AVE
Second Line : #307
City : LANSDOWNE
State : VA
Zip : 20176-8452
Country : US
Telephone Number : 703-350-1346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. GABRIELLE L ANDERSON LMFT” Practice Location

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