Sandra Giles Boo, LCSW

Individual provider Active NPI Clinical Social Worker · Centreville, VA

NPI 1255656369 · NPPES record last updated Mar 31, 2010

Key facts

NPI
1255656369
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0904007146 (VA)
Practice address
14474 Glencrest Cir
Centreville, VA 20120-4132
Phone
(571) 522-6130
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0904007146VAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904007146 VA Yes

Addresses

Primary practice location

14474 Glencrest Cir
Centreville, VA 20120-4132

Mailing address

14474 Glencrest Cir
Centreville, VA 20120-4132
Phone (571) 522-6130

Other providers in Centreville, VA

All providers in Centreville, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.