Individual
ANGEL BOUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 TECHNOLOGY DR, ROCKY MOUNT, VA 24151-3008
(540) 483-5044
(276) 632-0995
Mailing address
24 CLAY ST, MARTINSVILLE, VA 24112-2810
(276) 632-7128
(276) 632-0995
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009606
VA
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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