Individual
RICHARD CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
4320 PRINCE WILLIAM PKWY STE 109, WOODBRIDGE, VA 22192
(703) 680-4200
Mailing address
4320 PRINCE WILLIAM PKWY STE 109, WOODBRIDGE, VA 22192-8100
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005476
VA
103TC2200X
Clinical Child & Adolescent Psychologist
0810005476
VA
103TF0000X
Family Psychologist
0810005476
VA
103TF0200X
Forensic Psychologist
0810005476
VA
103TP2701X
Group Psychotherapy Psychologist
0810005476
VA
Other
Enumeration date
11/03/2016
Last updated
01/17/2019
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