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Organization
MOUNTAIN LAUREL GROUP, LLC
Active
Organization
MOUNTAIN LAUREL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE C. WYMAN EDM.,NCC,LPC (CEO/ DIRECTOR)
(540) 829-1789
Entity
Organization
Contact information
Practice address
102 N MAIN ST STE 300, CULPEPER, VA 22701-3053
(540) 829-1789
(540) 829-0117
Mailing address
102 N MAIN ST STE 300, CULPEPER, VA 22701-3053
(540) 829-1789
(540) 829-0117
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003919
VA
Other
Enumeration date
04/30/2010
Last updated
01/26/2012
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