Individual
DR. GWENDOLYN RENEE DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(757) 395-0842
Mailing address
301 GREEN ST APT 4E, PORTSMOUTH, VA 23704-2470
(757) 395-0842
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810004452
VA
Other
Enumeration date
04/02/2012
Last updated
10/18/2018
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