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1902282684
JACQUELINE BLAKE
FAIRFAX, VA
NPI
1902282684
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904009033)
Enumeration Date
2015-08-05
Last Update Date
2015-08-05
Business Address
-- JACQUELINE BLAKE LCSW
8221 WILLOW OAKS CORPORATE DR 2-217E.01
FAIRFAX, VA 22031-4512
Phone number: 703-207-6976
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Mailing Address
-- JACQUELINE BLAKE LCSW
8221 WILLOW OAKS CORPORATE DR 2-217E.01
FAIRFAX, VA 22031-4512
Phone number: 703-207-6976
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