Individual
GERALDINE MBONEFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5417 KIMBERMERE CT, GLEN ALLEN, VA 23060-9253
(804) 308-3890
Mailing address
PO BOX 70564, RICHMOND, VA 23255-0564
(804) 308-3890
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
06/11/2022
Last updated
06/11/2022
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