Individual provider · NPI-1

Gayle Marie Breeden

Social Worker, Clinical · Ashburn, VA

NPI number1780101261
StatusActive
Last updated in NPPESAug 25, 2017

Details

NPI
1780101261
Entity type
Individual (NPI-1)
Name
Gayle Marie Breeden
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 25, 2017
Last updated
Aug 25, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical0904002134VAYes

Other names

  • Gayle Marie Glasmire (Former Name)

Practice location

44790 Maynard Square, Suite 130
Ashburn, VA 20147-6514

Phone 703-542-3737 · Fax 703-584-7378

Mailing address

44790 Maynard Sq
Ashburn, VA 20147-6513

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