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Individual

MS. EMMA L SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CSOTP

Contact information

Practice address
514 E ATLANTIC ST, SOUTH HILL, VA 23970-2704
(434) 949-6360
Mailing address
PO BOX 211, ALBERTA, VA 23821-0211
(434) 949-6360

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0812000550
VA
101YP2500X
Professional Counselor
Primary
0701003580
VA

Other

Enumeration date
10/11/2007
Last updated
10/11/2007
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