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Individual

EBONY NICOLE CALLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
16712 JEFFERSON DAVIS HWY, DUMFRIES, VA 22026-2115
(703) 221-7467
(703) 221-4115
Mailing address
16712 JEFFERSON DAVIS HWY, DUMFRIES, VA 22026-2115
(703) 221-7467
(703) 221-4115

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010339
VA
1041C0700X
Clinical Social Worker
LC50080428
DC
1041C0700X
Clinical Social Worker
SW12357
FL

Other

Enumeration date
04/22/2017
Last updated
03/14/2024
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