Individual
MRS. CHARLENE THEPSIMUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
707 5TH ST NE, ROANOKE, VA 24016-2123
(540) 819-3622
Mailing address
7211 CLOVERDALE RD, ROANOKE, VA 24019-8221
(540) 966-5808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009781
VA
Other
Enumeration date
03/04/2017
Last updated
11/10/2020
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