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Organization
DEAN VINES ENTERPRISES
Active
Organization
DEAN VINES ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDDIE DEAN VINES (PRESIDENT)
(757) 873-2307
Entity
Organization
Contact information
Practice address
703 THIMBLE SHOALS BLVD, A-3, NEWPORT NEWS, VA 23606-2576
(757) 873-2307
Mailing address
703 THIMBLE SHOALS BLVD, A-3, NEWPORT NEWS, VA 23606-2576
(757) 873-2307
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002078
VA
Other
Enumeration date
03/14/2006
Last updated
08/22/2020
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