Organization
THERAPEUTIC IN HOME COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LISA SMITH (HOUSE SUPERVISOR)
(804) 640-2101
Entity
Organization
Contact information
Practice address
1949 VESONDER RD, PETERSBURG, VA 23805-2933
(804) 640-2101
(877) 879-6336
Mailing address
1949 VESONDER RD, PETERSBURG, VA 23805-2933
(804) 722-1185
(877) 879-6336
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1261
VA
Other
Enumeration date
08/27/2008
Last updated
11/20/2009
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