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JACQUELINE PATRICIA LYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
12359 SUNRISE VALLEY DR STE 320, RESTON, VA 20191-3463
(703) 596-4796
Mailing address
12359 SUNRISE VALLEY DR STE 320, RESTON, VA 20191-3463
(703) 596-4796

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0704012975
VA
101YP2500X
Professional Counselor
Primary
0701011418
VA

Other

Enumeration date
12/28/2020
Last updated
05/18/2022
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