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General NPI Number Information
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NPI Number | 1497395016
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Entity Type | Individual
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Provider Name | RENEE CAROL GATES MSW
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Gender | Female
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Dates
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Enumeration Date | 01/11/2020
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Last Update Date | 01/11/2020
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Provider Practice Location Address
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Address Line | 11903 MAIN ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-7326
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Country | US
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Telephone | 856-912-0314
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Fax |
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Provider Business Mailing Address
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Address Line | 13006 DUBIN DR
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City | SPOTSYLVANIA
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State | VA
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Zip | 22551-8012
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Country | US
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Telephone | 540-684-8962
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Fax | 540-940-6522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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