Individual
MRS. GWENDOLYN DANIELS SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RESIDENT COUNSELOR
Contact information
Practice address
9 CANOE CT, PORTSMOUTH, VA 23703-5380
(757) 673-3644
(757) 337-0165
Mailing address
9 CANOE CT, PORTSMOUTH, VA 23703-5380
(757) 675-5416
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
VA
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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