Individual
MISS BRENDA SUE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5610 SANDY LEWIS DR STE A, FAIRFAX, VA 22032-4045
(703) 425-8269
(703) 425-6020
Mailing address
RR 3 BOX 572, JONESVILLE, VA 24263-9605
(276) 346-4437
(276) 546-4491
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005632
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182179
BC/BS VIRGINIA
VA
Enumeration date
07/05/2006
Last updated
07/08/2007
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