Individual
CHARONTA QUINETTE PEGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 WEST LN, PETERSBURG, VA 23803-5312
(804) 943-5661
Mailing address
1720 WEST LN, PETERSBURG, VA 23803-5312
(804) 943-5661
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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