Ellis, Mary Anne

Ellis, Mary Anne is an individual health care provider with primary practice located at 133 Park St Ne , Vienna VA 22180-4602. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Ellis, Mary Anne can be contacted via phone (703) 281-2657.

Contact Information

Primary practice address
133 Park St Ne Vienna VA 22180-4602
Phone: (703) 281-2657
Fax: (703) 242-0014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 0810004323 Virginia

Profile Details

NPI number 1972813467
LBN Legal business name Ellis, Mary Anne
Credentials JD,PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2010
Last updated Oct 18th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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