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Individual

JILL H FARRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1657 MERRIMAC TRL, WILLIAMSBURG, VA 23185-5624
(757) 220-3200
(757) 253-4371
Mailing address
403 BROKENBRIDGE RD, YORKTOWN, VA 23692-4713
(757) 810-8901
(757) 253-4118

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0904003276
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
266051
ANTHEM
VA
01
363321
MANAGED HEALTH NET
VA
01
527375
VALUE OPTIONS
VA
01
527380
VALUE OPTIONS
VA
Enumeration date
01/08/2007
Last updated
07/08/2007
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