Individual
DONNA KELLEY MAUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
241 GREENHOUSE RD, LEXINGTON, VA 24450-3717
(540) 463-3141
(540) 464-4051
Mailing address
241 GREENHOUSE RD, LEXINGTON, VA 24450-3717
(540) 463-3141
(540) 464-4051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710001198
VA
1041C0700X
Clinical Social Worker
Primary
0904004291
VA
Other
Enumeration date
04/07/2006
Last updated
11/15/2007
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