Landers, Audrey Doris

Landers, Audrey Doris is an individual health care provider with primary practice located at 1241 Mall Dr , Richmond VA 23235-4737. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Landers, Audrey Doris can be contacted via phone (804) 794-3631.

Contact Information

Primary practice address
1241 Mall Dr Richmond VA 23235-4737
Phone: (804) 794-3631
Fax: (804) 379-6385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810001071 Virginia

Profile Details

NPI number 1073500575
LBN Legal business name Landers, Audrey Doris
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Jul 8th, 2007 - about 17 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 1073500575 NPPES
Virginia MEDICAID 7723555

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