Individual
GLORIA LARSON-JADALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4113 STEVENSON ST, STEVENSON PLACE, FAIRFAX, VA 22030-5617
(703) 460-6200
(703) 277-7090
Mailing address
10010 SUDLEY MANOR DR, MANASSAS, VA 20109-6235
(703) 257-9449
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0001078585
VA
Other
Enumeration date
02/14/2007
Last updated
07/08/2007
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