Individual
MRS. MICHELLE WALRAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
25 S GATEWAY DR, T-2175, FREDERICKSBURG, VA 22406-1228
(540) 374-4821
(540) 374-4831
Mailing address
25 S GATEWAY DR, T-2175, FREDERICKSBURG, VA 22406-1228
(540) 374-4821
(540) 374-4831
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230007988
VA
183700000X
Pharmacy Technician
290101040759955
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230007988
COMMONWEALTH OF VIRGINIA STATE LICENSE
—
01
—
290101040759955
PHARMACY TECHNICIAN CERTIFICATION BOARD
—
Enumeration date
02/04/2015
Last updated
02/04/2015
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