Individual
JULIE E EBERSOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, QMHP-C
Contact information
Practice address
2008 BREMO RD STE 111, RICHMOND, VA 23226-2443
(804) 404-6105
Mailing address
119 QUAIL HOLLOW DR, WOODSTOCK, VA 22664-4027
(540) 325-7234
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0733006794
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351348766012
—
VA
Enumeration date
11/21/2022
Last updated
11/21/2022
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