Individual
IMONI MALIKA PATRICE WOODBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
20 W BANK ST, PETERSBURG, VA 23803-3279
(804) 862-8000
Mailing address
3613 LUCKYLEE CRES, NORTH CHESTERFIELD, VA 23234-5709
(804) 840-6596
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012201
VA
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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