Organization
ELTON'S SOUL TO SOUL COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE CARPENTER ELTON LCSW (PROVIDER)
(540) 353-2244
Entity
Organization
Contact information
Practice address
3247 ELECTRIC RD STE 1A, ROANOKE, VA 24018-6448
(540) 772-0690
(540) 772-0692
Mailing address
6776 HIDDEN WOODS DR, ROANOKE, VA 24018-7480
(540) 353-2244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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