Organization
SUSAN A. PONTON THERAPIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN ALLEN PONTON LPC (LICENSE PROFESSIONAL COUNSELOR)
(434) 447-7447
Entity
Organization
Contact information
Practice address
501 N MECKLENBURG AVE, SOUTH HILL, VA 23970-2024
(434) 447-7447
(434) 447-3057
Mailing address
PO BOX 809, SOUTH HILL, VA 23970-0809
(434) 447-7447
(434) 447-3057
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0701003560
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010030692
—
VA
Enumeration date
06/20/2008
Last updated
06/20/2008
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