Individual
MRS. M SUZANNE SOUDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
113 DMV DRIVE, KILMARNOCK, VA 22482
(804) 435-9237
(804) 435-9438
Mailing address
902 OAK LANE, KILMARNOCK, VA 22482
(804) 436-3358
(804) 435-9438
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0904005891
VA
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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