Organization
RAPPAHANNOCK AREA CSB
Active
Other names
PEID
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENDA DUBOSE (CREDENTIALING COORDINATOR)
(540) 373-3223
Entity
Organization
Contact information
Practice address
600 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 373-3223
(540) 371-3753
Mailing address
600 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 373-3223
(540) 371-3753
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978145
—
VA
Enumeration date
04/13/2007
Last updated
08/15/2024
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