Individual
MISS ELIZABETH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCA
Contact information
Practice address
5010 UNSELD BLVD, LOUISVILLE, KY 40218-3836
(502) 479-5699
Mailing address
3030 KIM DR, NORTH CHESTERFIELD, VA 23224-5643
(502) 435-8295
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E026044
VA
347C00000X
Private Vehicle
A63489901
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E026044
—
VA
Enumeration date
06/20/2013
Last updated
12/08/2015
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