Individual
DAMIAN AYALA
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
Mailing address
301 ELM AVE SW, ROANOKE, VA 24016-4001
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701008292
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437137734
—
VA
Enumeration date
04/29/2019
Last updated
04/29/2019
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