Individual
JENNIFER SPEED BYRNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
501 CHURCH ST NE STE 106, VIENNA, VA 22180-4734
(720) 320-9059
Mailing address
PO BOX 2924, LA PLATA, MD 20646-2984
(301) 609-9887
(301) 609-9091
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
MD
101YP2500X
Professional Counselor
Primary
0701006184
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589561803
—
MD
Enumeration date
11/01/2011
Last updated
10/18/2018
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