Individual
DR. PHYLLIS MARGO ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5675 STONE RD, SUITE 320, CENTREVILLE, VA 20120-1667
(703) 803-7450
(703) 830-0001
Mailing address
6301 BARNESDALE PATH, CENTREVILLE, VA 20120-3900
(703) 803-7450
(703) 830-0001
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002250
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086106
ANTHEM
VA
01
—
B607
BC BS NCA
VA
Enumeration date
01/03/2007
Last updated
07/08/2007
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