Organization
D'VINE INTERVENTION COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETESHA RENEE' GIBSON LPC (CHRISTIAN THERAPIST/OWNER)
(252) 673-3196
Entity
Organization
Contact information
Practice address
2424 OAK STREET, PORTSMOUTH, VA 27870
(252) 673-3196
Mailing address
116 PIEDMONT COURT, ROANOKE RAPIDS, NC 27870
(252) 673-3196
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0701005691
VA
Other
Enumeration date
04/07/2015
Last updated
04/14/2015
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