Individual
MR. EUGENE GILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6210 OLD FRANCONIA RD UNIT A, ALEXANDRIA, VA 22310-2529
(703) 955-3703
Mailing address
6210 OLD FRANCONIA RD UNIT A, ALEXANDRIA, VA 22310-2529
(703) 955-3703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904016372
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
12/17/2014
Last updated
12/27/2024
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