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Organization
MOMENTUM COUNSELING AND WELLNESS LLC
Active
Organization
MOMENTUM COUNSELING AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRIE LYNNE BOGAZ LCSW (OWNER)
(804) 437-2599
Entity
Organization
Contact information
Practice address
431 WALTON PARK ROAD, MIDLOTHIAN, VA 23114
(804) 437-2599
Mailing address
431 WALTON PARK ROAD, MIDLOTHIAN, VA 23114
(804) 437-2599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006987
VA
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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