# PRATIBHA SRINIVASAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SMART EARS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720391600
- **Authorized official:** MS. PRATIBHA SRINIVASAN (SOLE PROPRIETOR AND AUDIOLOGIST)
- **Authorized official phone:** (804) 399-4066

## Contact information

- **Practice address:** 220 S WASHINGTON ST, \#203, ALEXANDRIA, VA 22314-3626
- **Practice address phone:** (804) 399-4066
- **Practice address fax:** (703) 891-9854
- **Mailing address:** 1019 DAWNWOOD RD, MIDLOTHIAN, VA 23114-4489
- **Mailing address phone:** (804) 399-4066
- **Mailing address fax:** (703) 891-9854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 2201000379 | VA | Yes |

## Other

- **Enumeration date:** 07/20/2010
- **Last updated:** 07/20/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 352434 | ANTHEM | VA |
| 05 | — | 9450025 | — | VA |
| 01 | — | M986 | CAREFIRST BCBS | VA |