Organization
ALTITUDE IOP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA SOUKUP LMFT (PROGRAM THERAPIST)
(540) 953-5090
Entity
Organization
Contact information
Practice address
708 S MAIN ST, BLACKSBURG, VA 24060-5210
(540) 953-5090
(540) 953-5095
Mailing address
708 S MAIN ST, BLACKSBURG, VA 24060-5210
(540) 953-5090
(540) 953-5095
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001173
VA
133V00000X
Registered Dietitian
953736
VA
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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