Individual
MARLISE BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6225 BRANDON AVE STE 130, SPRINGFIELD, VA 22150-2519
(703) 569-7500
Mailing address
2024 TAMANI DR, HERNDON, VA 20170-4048
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119010793
VA
Other
Enumeration date
01/20/2025
Last updated
02/24/2025
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