Clemens, Erin Marie

Clemens, Erin Marie is an individual health care provider with primary practice located at 2235 Tacketts Mill Dr Suite C, Woodbridge VA 22192-3036. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Clemens, Erin Marie can be contacted via phone (703) 491-1044.

Contact Information

Primary practice address
2235 Tacketts Mill Dr Suite C Woodbridge VA 22192-3036
Fax: (703) 491-2044
Website:

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 0119005220 Virginia

Profile Details

NPI number 1457418121
LBN Legal business name Clemens, Erin Marie
Credentials OTRL
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Sep 4th, 2012 - about 14 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 1457418121 NPPES
North Carolina Other 142TP BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 7301756 BLUE CROSS BLUE SHIELD

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