Individual
MS. LAURA R SIMMONS-FONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
10455 WHITE GRANITE DR STE 400, OAKTON, VA 22124-2764
(703) 536-9000
Mailing address
10455 WHITE GRANITE DR STE 400, OAKTON, VA 22124-2764
(703) 536-9000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003597
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105700
BLUE CROSS BLUE SHIELD
VA
01
—
292848
AMERIGROUP
VA
05
—
4945247
—
VA
Enumeration date
03/21/2007
Last updated
10/01/2024
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