Individual
MS. ELAINE P BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 CHURCH ST NE STE 206, VIENNA, VA 22180-4734
(703) 255-2208
(703) 255-2482
Mailing address
501 CHURCH ST NE STE 206, VIENNA, VA 22180-4734
(703) 255-2208
(703) 255-2482
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003838
VA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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