Individual
GAIL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, MED
Contact information
Practice address
621 W MAIN ST, PURCELLVILLE, VA 20132-3012
(571) 420-0040
Mailing address
PO BOX 1043, LEESBURG, VA 20177-1043
(571) 420-0040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904014470
VA
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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