Individual
JACQUELYN MARIE BRANNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109
(703) 792-7800
(703) 792-5699
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009902
VA
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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