Individual
DR. LISA BETHANY MAGAZINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6610 COMMONS DR, STE #103, PRINCE GEORGE, VA 23875-2528
(804) 722-0620
(804) 722-0621
Mailing address
6610 COMMONS DR, STE #103, PRINCE GEORGE, VA 23875-2528
(804) 722-0620
(804) 722-0621
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003813
VA
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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