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Individual

MILICENT ANN MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
5009 POTOMAC HIGHLANDS CIR, TRIANGLE, VA 22172-1780
(908) 662-4844
Mailing address
5009 POTOMAC HIGHLANDS CIR, TRIANGLE, VA 22172-1780
(908) 662-4844

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903003824
VA
1041C0700X
Clinical Social Worker
0906013351
VA

Other

Enumeration date
07/27/2023
Last updated
07/27/2023
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