Provider Demographics
NPI:1245922178
Name:ECTOR, BRIANNA LA NYCE (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:LA NYCE
Last Name:ECTOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 LES DORSON LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-3228
Mailing Address - Country:US
Mailing Address - Phone:571-221-7048
Mailing Address - Fax:
Practice Address - Street 1:10513 JUDICIAL DR STE 301
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7528
Practice Address - Country:US
Practice Address - Phone:703-966-5173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008176103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical