Individual
TERESA GAIL GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
502 BEECH ST, FARMVILLE, VA 23901-1222
(434) 414-8308
Mailing address
217 HARRIS SPRING RD, BURKEVILLE, VA 23922-3122
(434) 390-8036
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0701005152
VA
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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