Organization
CREATIVE COUNSELING AND CONSULTATIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATERESEA L FORD PHD (OWNER)
(804) 525-4101
Entity
Organization
Contact information
Practice address
2423 LAMB AVE, RICHMOND, VA 23222-4419
(804) 525-4101
(804) 525-4102
Mailing address
2423 LAMB AVE, RICHMOND, VA 23222-4419
(804) 525-4101
(804) 525-4102
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005286
VA
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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