Wilson Dallas, Mercedes E.

Wilson Dallas, Mercedes E. is an individual health care provider with primary practice located at 720 N Saint Asaph St Fourth Floor, Alexandria VA 22314-1912. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wilson Dallas, Mercedes E. can be contacted via phone (703) 838-6400.

Contact Information

Primary practice address
720 N Saint Asaph St Fourth Floor Alexandria VA 22314-1912
Phone: (703) 838-6400
Fax: (703) 838-5070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810001425 Virginia

Profile Details

NPI number 1811044381
LBN Legal business name Wilson Dallas, Mercedes E.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Jul 9th, 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 1811044381 NPPES
Virginia Other 270291 AMERIGROUP
Virginia Other 0025 AMERIGROUP
Virginia Other 008746A25 AMERIGROUP
Virginia Other 188512 AMERIGROUP
Virginia Other 546001103002 AMERIGROUP

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