Individual
TIONNA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 STIGALL DR, MIDLOTHIAN, VA 23112-3217
(804) 484-0899
Mailing address
212 SCRIMSHAW DR, CHESTER, VA 23836-2573
(804) 484-0899
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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