Individual
MS. JACQUELINE LEIGH TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2504 PATRICK ST, VIENNA, VA 22180-6844
(703) 207-9136
(703) 207-9740
Mailing address
2516 N DEARING ST, ALEXANDRIA, VA 22302-1807
(703) 820-7239
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005809
VA
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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