Healthcare Provider Details

I. General information

NPI: 1629989587
Provider Name (Legal Business Name): LILIANE SAMPSON DEAN M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 OLD BUCKINGHAM RD
POWHATAN VA
23139-5757
US

IV. Provider business mailing address

3910 OLD BUCKINGHAM RD
POWHATAN VA
23139-5757
US

V. Phone/Fax

Practice location:
  • Phone: 804-598-2200
  • Fax: 804-556-9165
Mailing address:
  • Phone: 804-598-2200
  • Fax: 804-556-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License NumberPGP-0653228
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: