Individual
TINA COLONESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CSOTP
Contact information
Practice address
4901 E PATRICK HENRY HWY, BURKEVILLE, VA 23922-3454
(804) 766-3173
Mailing address
4901 E PATRICK HENRY HWY, BURKEVILLE, VA 23922-3454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0812000826
VA
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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