Individual
GWEN HUMPHREY CORLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
116 E CORK ST, WINCHESTER, VA 22601-5023
(540) 722-0562
(540) 722-1081
Mailing address
116 E CORK ST, WINCHESTER, VA 22601-5023
(540) 722-0562
(540) 722-1081
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002201
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088773
OPTIMA
VA
05
—
8905983
—
VA
Enumeration date
07/14/2006
Last updated
07/08/2007
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