Individual
CANAN DYSERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3815 MARQUIS PL, WOODBRIDGE, VA 22192-6228
(703) 590-9874
Mailing address
3815 MARQUIS PL, WOODBRIDGE, VA 22192-6228
(703) 590-9874
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
2355S0801X
Speech-Language Assistant
—
—
Other
Enumeration date
03/07/2023
Last updated
08/26/2023
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