Individual
FREDDIE DEAN VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
703 THIMBLE SHOALS BLVD, A-3, NEWPORT NEWS, VA 23606-2576
(757) 873-2307
Mailing address
8589 E CREEK LN, HAYES, VA 23072-3748
(757) 873-2307
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002078
VA
Other
Enumeration date
03/14/2006
Last updated
01/17/2008
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