Individual
GAYLE JACKSON-LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
(804) 675-6244
Mailing address
8013 MOSS GATE CT, RICHMOND, VA 23227-1673
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903001571
VA
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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