Provider Demographics
NPI:1730775123
Name:LETOILE, ANALISSE
Entity type:Individual
Prefix:
First Name:ANALISSE
Middle Name:
Last Name:LETOILE
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 1:7379 IRON BIT DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-6122
Mailing Address - Country:US
Mailing Address - Phone:571-212-1350
Mailing Address - Fax:
Practice Address - Street 1:7379 IRON BIT DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-6122
Practice Address - Country:US
Practice Address - Phone:571-212-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program