Individual
DR. LIANNA R BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
3607 CHAIN BRIDGE RD, STE A, FAIRFAX, VA 22030-3242
(703) 307-1893
Mailing address
3607 CHAIN BRIDGE RD, STE A, FAIRFAX, VA 22030-3242
(703) 307-1893
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004641
VA
Other
Enumeration date
08/10/2010
Last updated
10/12/2012
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