Individual
MR. RODNEY LEVI WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA-CSAC-QMHP
Contact information
Practice address
8180 HAMILTON DR, GLOUCESTER, VA 23061-5296
(804) 824-2300
Mailing address
8180 HAMILTON DR, GLOUCESTER, VA 23061-5296
(804) 824-2300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710101903
VA
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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