Provider Demographics
NPI:1952756595
Name:TOWNSEND, DIANA ANDERSON (MS)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:ANDERSON
Last Name:TOWNSEND
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 1:9508 QUAIL POINTE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3317
Mailing Address - Country:US
Mailing Address - Phone:571-334-2375
Mailing Address - Fax:
Practice Address - Street 1:21576 IREDELL TER
Practice Address - Street 2:
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-5033
Practice Address - Country:US
Practice Address - Phone:510-738-7709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1235381633103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst