Individual
MR. TODD DOUGLAS STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3517 BRANDON AVE SW, ROANOKE, VA 24018-1523
(540) 981-1102
(540) 344-4169
Mailing address
301 ELM AVE SW, ROANOKE, VA 24016-4001
(540) 981-1102
(540) 344-4169
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701005019
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437137734
—
VA
Enumeration date
03/17/2011
Last updated
03/17/2011
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