Individual
MRS. KATHLEEN MARCHELLO GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3750 OLD LEE HIGHWAY, INFANT & TODDLER CONNECTION, FAIRFAX, VA 22030
(703) 246-7180
(703) 246-7307
Mailing address
4804 FOX CHAPEL RD, FAIRFAX, VA 22030-4509
(703) 246-7138
(703) 246-7307
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003371
VA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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