Basic Information
| Provider Information | |||||||||
| NPI: | 1437330685 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANNA LEE HOODEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 ORDWAY ST NW | ||||||||
| Address2: | #460 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200163175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016569520 | ||||||||
| FaxNumber: | 3017183633 | ||||||||
| Practice Location | |||||||||
| Address1: | 7910 WOODMONT AVE | ||||||||
| Address2: | SUITE 460 | ||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208143002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016569520 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2007 | ||||||||
| LastUpdateDate: | 11/16/2007 | ||||||||
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| AuthorizedOfficialLastName: | SILBERFELD | ||||||||
| AuthorizedOfficialFirstName: | RANDEE | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLER | ||||||||
| AuthorizedOfficialTelephone: | 8006506334 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | G01863 | 01 | DC | MEDICARE DC/METRO AREA | OTHER |