Individual
MRS. MALISSA ANN QUINLAN FARNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC-S
Contact information
Practice address
10543 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(804) 223-5141
Mailing address
10543 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(180) 422-3514
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0709024879
VA
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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