# CENTER OF INTEGRATIVE MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184877961
- **Authorized official:** MRS. YEDDA STANCIL (OFFICE MANAGER/OWNER)
- **Authorized official phone:** (804) 353-9355

## Contact information

- **Practice address:** 3536 GROVE AVE, RICHMOND, VA 23221-2200
- **Practice address phone:** (804) 353-9355
- **Practice address fax:** (804) 359-8344
- **Mailing address:** 3536 GROVE AVE, RICHMOND, VA 23221-2200
- **Mailing address phone:** (804) 353-9355
- **Mailing address fax:** (804) 353-9383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 173C00000X | Reflexologist | — | NULL | — |
| 173C00000X | Reflexologist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/24/2008
- **Last updated:** 11/25/2009