Individual
MELANIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, ATR-BC, CTS
Contact information
Practice address
224 N MAIN ST, SUITE 217, HOPEWELL, VA 23860-2720
(804) 892-9262
(804) 732-8233
Mailing address
PO BOX 3144, PETERSBURG, VA 23805-3144
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005249
VA
221700000X
Art Therapist
08-136
NC
221700000X
Art Therapist
08-136
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114272929
—
VA
Enumeration date
07/17/2012
Last updated
04/16/2015
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