Provider Demographics
NPI:1235725581
Name:MADER, ANNE LEE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:LEE
Last Name:MADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10702 ZION DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-3432
Mailing Address - Country:US
Mailing Address - Phone:571-218-2002
Mailing Address - Fax:
Practice Address - Street 1:2001 S ST NW STE 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1164
Practice Address - Country:US
Practice Address - Phone:678-995-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical