Individual
DR. JENNIE LYNN CRIM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
10560 MAIN ST STE 507, FAIRFAX, VA 22030
(703) 691-1326
(703) 691-3553
Mailing address
PO BOX 3011, MERRIFIELD, VA 22116
(703) 798-3907
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810002053
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703872
—
VA
Enumeration date
05/26/2006
Last updated
07/08/2007
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