Individual
JENNIFER LYNN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2501 HUNTER PL STE 201, WOODBRIDGE, VA 22192-3940
(703) 659-9867
Mailing address
10391 GREYSON LN, RIXEYVILLE, VA 22737-1730
(540) 937-2334
(540) 937-7680
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50078156
DC
Other
Enumeration date
07/19/2012
Last updated
02/06/2013
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