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1831589233
BETHANY CORLISS
CHANTILLY, VA
NPI
1831589233
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: VA 0810004470)
Enumeration Date
2015-01-23
Last Update Date
2015-01-23
Business Address
-- BETHANY CORLISS PhD
14110 ROBERT PARIS CT
CHANTILLY, VA 20151-4205
Phone number: 703-378-7998
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Mailing Address
-- BETHANY CORLISS PhD
13945 LEETON CIR
CHANTILLY, VA 20151-2237
Phone number: 703-887-1807
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