Individual
ELYSSA BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4530
(571) 423-4900
Mailing address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4530
(571) 423-4900
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-0607528
VA
171M00000X
Case Manager/Care Coordinator
PPS-0607528
VA
Other
Enumeration date
10/17/2019
Last updated
12/16/2025
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