Organization
RECOVERING LIFE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WILMA LOIS MCGLOTHLIN (PRESIDENT/OWNER, RECOVERING LIFE PC)
(276) 889-1954
Entity
Organization
Contact information
Practice address
750 EAST MAIN STREET, LEBANON, VA 24266-2045
(276) 889-1954
(276) 889-4955
Mailing address
PO BOX 2045, LEBANON, VA 24266-2045
(276) 889-1954
(276) 889-4955
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447309828
—
VA
Enumeration date
01/09/2007
Last updated
07/29/2009
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