Individual
JESSICA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QP, MSW, PLCSW
Contact information
Practice address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(301) 703-8767
(301) 703-8886
Mailing address
4508 BRACADA DR, DURHAM, NC 27705-1653
(919) 351-5325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P007454
NC
Other
Enumeration date
06/18/2012
Last updated
05/13/2020
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