| Anupama Kommu | |
|
493 Blackwell Rd Suite 203 Warrenton VA 20186 | |
| (571) 364-3095 | |
| (540) 341-7091 |
| Full Name | Anupama Kommu |
|---|---|
| Speciality | Psychologist |
| Location | 493 Blackwell Rd, Warrenton, Virginia |
| Authorized Official Name and Position | Anupama T Kommu (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5713643095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anupama Kommu 4441 Corral Rd Warrenton VA 20187 Ph: (571) 364-3095 | Anupama Kommu 493 Blackwell Rd Suite 203 Warrenton VA 20186 Ph: (571) 364-3095 |
| NPI Number | 1134554793 |
|---|---|
| Provider Enumeration Date | 09/13/2013 |
| Last Update Date | 10/29/2019 |
| Medicare PECOS PAC ID | 9638304884 |
|---|---|
| Medicare Enrollment ID | O20131024001746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134554793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810004824 (Virginia) | Primary |
| Provider Name | Anupama Kommu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518392760 PECOS PAC ID: 0547495798 Enrollment ID: I20131205000272 |
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