Provider Demographics
NPI:1093883415
Name:KYSER, ELIZABETH ANN (PHD)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:KYSER
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WEST
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:8550 LEE HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1577
Practice Address - Country:US
Practice Address - Phone:703-207-2864
Practice Address - Fax:703-207-2838
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2021-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0810002696103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical