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NPI Code Detail

MEDICARE: ELIZABETH MOYER

MEDICARE: ELIZABETH MOYER
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
1101YM0800XMental Health Counselor0704010838VA

General Provider Information

NPI Number : 1841813599
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MOYER
Provider Business Mailing Address
First Line : 3259 HOLLY BERRY CT
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-3342
Country : US
Telephone Number : 813-390-5193
Fax Number :
Provider Business Practice Location Address
First Line : 112 S PITT ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-3112
Country : US
Telephone Number : 813-390-5193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2020
Last Update Date : 05/28/2020

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