Individual
DEBRA TISLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED., QMHPC-T,
Contact information
Practice address
11711 LAKEWOOD LN, FAIRFAX STATION, VA 22039-2102
(571) 302-6287
Mailing address
5765F BURKE CENTRE PKWY # 112, BURKE, VA 22015-2233
(571) 302-6287
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/16/2024
Last updated
11/16/2024
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