Provider Demographics
NPI:1780742791
Name:SPRING, ELIZABETH (MS)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:SPRING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 ISAAC NEWTON SQ W
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5038
Mailing Address - Country:US
Mailing Address - Phone:703-975-2628
Mailing Address - Fax:
Practice Address - Street 1:1984 ISAAC NEWTON SQ W
Practice Address - Street 2:SUITE 204
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5038
Practice Address - Country:US
Practice Address - Phone:703-975-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001038106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist