Organization
MYSPECTRUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE CHRISTOPHER (DIRECTOR)
(804) 332-5696
Entity
Organization
Contact information
Practice address
707 N COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-4045
(804) 332-5696
(866) 626-4469
Mailing address
707 N COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-4045
(804) 332-5696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174029359
—
VA
Enumeration date
04/05/2018
Last updated
06/21/2019
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