Organization
LIVEWELL BEHAVIORAL HEALTH
Active
Organization
LIVEWELL BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANISHA BRACEY PSY.D. (OWNER/CLINICAL PSYCHOLOGIST)
(202) 277-9687
Entity
Organization
Contact information
Practice address
2135 ABBOTTSBURY WAY, WOODBRIDGE, VA 22191-4098
(202) 277-9687
Mailing address
15000 POTOMAC TOWN PL, SUITE 100, #506, WOODBRIDGE, VA 22191
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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