Willow Psychiatry Limited | |
20925 Professional Plz 310 Ashburn VA 20147-3403 | |
(571) 620-5151 | |
(571) 421-1963 |
Full Name | Willow Psychiatry Limited |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 20925 Professional Plz, Ashburn, Virginia |
Authorized Official Name and Position | Radha Gayatri Agepati (PRESIDENT) |
Authorized Official Contact | 5716205151 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Willow Psychiatry Limited 41912 Clover Valley Ct Ashburn VA 20148-1765 Ph: (571) 620-5151 | Willow Psychiatry Limited 20925 Professional Plz 310 Ashburn VA 20147-3403 Ph: (571) 620-5151 |
NPI Number | 1255722005 |
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Provider Enumeration Date | 02/16/2015 |
Last Update Date | 02/16/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255722005 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 0101254626 (Virginia) | Primary |
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