Individual
MR. MARK RICHARD WALDE LOEWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, RPT
Contact information
Practice address
10128 HULL STREET RD, MIDLOTHIAN, VA 23112-3300
(804) 276-5761
(804) 555-5555
Mailing address
10128 HULL STREET RD, MIDLOTHIAN, VA 23112-3300
(804) 276-5761
(804) 555-5555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701004844
VA
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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