Organization
BROAD ROCK COUNSELING AND TRAINING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOANN M. THOMAS-WILSON PHD. (PSYCHOLOGIST)
(804) 275-9980
Entity
Organization
Contact information
Practice address
2545 BELLWOOD ROAD, SUITE 112, RICHMOND, VA 23237-4481
(804) 275-9980
(804) 275-9981
Mailing address
2545 BELLWOOD ROAD, SUITE 112, RICHMOND, VA 23237-4481
(804) 275-9980
(804) 275-9981
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000972
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007700890
—
VA
Enumeration date
06/02/2008
Last updated
02/17/2012
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