| Child Custody Clinic Pllc | |
|
6 Pidgeon Hill Dr Ste 190 Sterling VA 20165-6104 | |
| (703) 973-3863 | |
| Not Available |
| Full Name | Child Custody Clinic Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6 Pidgeon Hill Dr Ste 190, Sterling, Virginia |
| Authorized Official Name and Position | Elizabeth Bennett (OWNER) |
| Authorized Official Contact | 7039733863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Custody Clinic Pllc 1901 Winterport Cluster Reston VA 20191-3623 Ph: (703) 973-3863 | Child Custody Clinic Pllc 6 Pidgeon Hill Dr Ste 190 Sterling VA 20165-6104 Ph: (703) 973-3863 |
| NPI Number | 1750042669 |
|---|---|
| Provider Enumeration Date | 01/03/2022 |
| Last Update Date | 01/03/2022 |
| Certification Date | 01/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750042669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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