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Individual

JILLIAN FORAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
707 N COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-4045
(804) 924-2236
Mailing address
1604 QUEENS POINT DR, HENRICO, VA 23238-3943
(804) 833-8864

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904015134
VA

Other

Enumeration date
05/01/2023
Last updated
05/01/2023
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