Individual
ELIZABETH SAN PEDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4850 MARK CENTER DR, ALEXANDRIA, VA 22311-1882
(703) 746-3400
(703) 746-3464
Mailing address
3800 POWELL LN, #616, FALLS CHURCH, VA 22041-3687
(703) 746-3444
(703) 746-3464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006893
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945026
—
VA
Enumeration date
10/30/2008
Last updated
06/13/2024
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