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Individual

DIANE BRISK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4213 WALNEY RD, CHANTILLY, VA 20151-2923
(702) 502-7000
Mailing address
4213 WALNEY RD, CHANTILLY, VA 20151-2923
(702) 502-7000

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
0001128523
VA

Other

Enumeration date
10/07/2008
Last updated
10/07/2008
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