Individual
MR. GARY HOWARD ROTFUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5265 PROVIDENCE RD, SUITE 500, VIRGINIA BEACH, VA 23464-4206
(757) 467-9500
(757) 467-9560
Mailing address
5265 PROVIDENCE RD, SUITE 500, VIRGINIA BEACH, VA 23464-4206
(757) 467-9500
(757) 467-9560
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904000552
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089022577
—
VA
Enumeration date
01/04/2007
Last updated
07/08/2007
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