Individual
TANISHA S BRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5403 CABOT RIDGE CT, FAIRFAX, VA 22032-3214
(202) 277-9687
(703) 250-3782
Mailing address
5403 CABOT RIDGE CT, FAIRFAX, VA 22032-3214
(202) 277-9687
(703) 250-3782
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004822
VA
Other
Enumeration date
07/15/2013
Last updated
05/07/2014
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