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Individual

MRS. JORDAN GULLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
800 JOHN CARLYLE ST APT 313, ALEXANDRIA, VA 22314-6849
(804) 366-6823
Mailing address
800 JOHN CARLYLE ST APT 313, ALEXANDRIA, VA 22314-6849
(804) 366-6823

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50081232
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
VARIOUS
DC
Enumeration date
12/10/2021
Last updated
12/10/2021
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