Provider Demographics
NPI:1033661434
Name:DILLARD, VERONICA MICHELLE (DSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:MICHELLE
Last Name:DILLARD
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8507 OXON HILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4774
Mailing Address - Country:US
Mailing Address - Phone:804-714-9256
Mailing Address - Fax:415-520-6633
Practice Address - Street 1:8507 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4766
Practice Address - Country:US
Practice Address - Phone:804-714-9256
Practice Address - Fax:415-520-6633
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500827241041C0700X
MD280101041C0700X
VA09040096091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical