Individual
BARBARA AILEEN FASICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP-A
Contact information
Practice address
20 W COURT ST, ROCKY MOUNT, VA 24151-1304
(540) 482-0164
(540) 264-3096
Mailing address
20 W COURT ST, ROCKY MOUNT, VA 24151-1304
(540) 482-0164
(540) 264-3096
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/11/2020
Last updated
11/12/2020
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