Individual
MS. ELEANOR IHMSEN MATTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
6073 ARLINGTON BLVD, FALLS CHURCH, VA 22044-2721
(703) 550-4334
Mailing address
6073 ARLINGTON BLVD, FALLS CHURCH, VA 22044-2721
(703) 550-4334
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002312
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F553-001
BLUE CROSS
VA
Enumeration date
01/02/2007
Last updated
12/08/2011
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