Individual
MRS. JENNIFER MICHELLE MADDOX-BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1815 SYCAMORE VALLEY DR APT 103, RESTON, VA 20190-4588
(646) 465-1982
Mailing address
1815 SYCAMORE VALLEY DR APT 103, RESTON, VA 20190-4588
(646) 465-1982
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
00107972
—
104100000X
Social Worker
92417
NY
1041C0700X
Clinical Social Worker
087515-01
NY
1041C0700X
Clinical Social Worker
Primary
0904016419
VA
Other
Enumeration date
12/17/2014
Last updated
12/28/2024
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