Individual
JAMALL TRIMAINE MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4126 DOMINION TOWNES CIR, RICHMOND, VA 23223-2292
(804) 658-3632
Mailing address
4126 DOMINION TOWNES CIR, RICHMOND, VA 23223-2292
(804) 658-3632
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2040-03-001
VA
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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