Individual
DOROTHY JACKSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
54 E LEE ST, WARRENTON, VA 20186-3325
(540) 347-0613
Mailing address
6121 BLANTYRE RD, BROAD RUN, VA 20137-1817
(540) 219-9001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904011386
VA
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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