Individual
DR. JENNIFER LYNN SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3554 CHAIN BRIDGE RD, SUITE 103, FAIRFAX, VA 22030-2709
(703) 896-7628
(703) 890-2359
Mailing address
3554 CHAIN BRIDGE RD, SUITE 103, FAIRFAX, VA 22030-2709
(703) 896-7628
(703) 890-2359
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004513
VA
Other
Enumeration date
12/13/2011
Last updated
12/15/2016
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