Individual
DR. LORI BRISTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6723 WHITTIER AVE, SUITE 206, MC LEAN, VA 22101-4522
(703) 477-0692
Mailing address
7600 LAKESIDE VILLAGE DR, UNIT D, FALLS CHURCH, VA 22042-7548
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810004605
VA
Other
Enumeration date
02/10/2013
Last updated
08/26/2016
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