Individual
DONNA LILIAN SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7501 EGYPT RD, NEW KENT, VA 23124-2123
Mailing address
1723 SUMMIT AVE APT 208, RICHMOND, VA 23230-4539
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010308
VA
Other
Enumeration date
01/08/2018
Last updated
03/17/2018
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