Individual
CLORIA ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3604 TEJO LN APT 2B, PORTSMOUTH, VA 23703-3032
(757) 237-3453
Mailing address
3604 TEJO LN APT 2B, PORTSMOUTH, VA 23703-3032
(757) 237-3453
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
740081019057
—
VA
Enumeration date
05/22/2019
Last updated
05/22/2019
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