| Elaine P. Boomer Pc | |
|
501 Church St Ne Suite 206 Vienna VA 22180-4734 | |
| (703) 255-2208 | |
| (703) 255-2482 |
| Full Name | Elaine P. Boomer Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 501 Church St Ne, Vienna, Virginia |
| Authorized Official Name and Position | Elaine P Boomer (PRESIDENT) |
| Authorized Official Contact | 7032552208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elaine P. Boomer Pc 501 Church St Ne Suite 206 Vienna VA 22180-4734 Ph: (703) 255-2208 | Elaine P. Boomer Pc 501 Church St Ne Suite 206 Vienna VA 22180-4734 Ph: (703) 255-2208 |
| NPI Number | 1285955021 |
|---|---|
| Provider Enumeration Date | 06/16/2010 |
| Last Update Date | 06/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285955021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904003838 (Virginia) | Primary |
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