Ivanisevic, Mirjana

Ivanisevic, Mirjana is an sole proprietor health care provider with primary practice located at 3300 Gallows Rd , Falls Church VA 22042-3307. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Ivanisevic, Mirjana can be contacted via phone (678) 697-7240.

Contact Information

Primary practice address
3300 Gallows Rd Falls Church VA 22042-3307
Phone: (678) 697-7240
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810007786 Virginia
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 0810007786 Virginia

Profile Details

NPI number 1326770603
LBN Legal business name Ivanisevic, Mirjana
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2022
Last updated Sep 9th, 2022 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1326770603 NPPES
Virginia Other 0810007786 VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS

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