Provider Demographics
NPI:1447891759
Name:ERICAGANTS.PH.D.PLLC
Entity type:Organization
Organization Name:ERICAGANTS.PH.D.PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:SARI
Authorized Official - Last Name:GANTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-568-2892
Mailing Address - Street 1:140 LITTLE FALLS ST STE 212
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4323
Mailing Address - Country:US
Mailing Address - Phone:703-568-2892
Mailing Address - Fax:703-536-1775
Practice Address - Street 1:140 LITTLE FALLS ST STE 212
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4323
Practice Address - Country:US
Practice Address - Phone:703-568-2892
Practice Address - Fax:703-536-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty