Individual
MACLOVIA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
289 INDEPENDENCE BLVD, VIRGINIA BEACH, VA 23462-5493
(757) 385-0850
Mailing address
289 INDEPENDENCE BLVD, VIRGINIA BEACH, VA 23462-5493
(757) 385-0850
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004401
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578851762
ANTHEM
VA
05
—
1861562472
—
VA
Enumeration date
07/21/2011
Last updated
04/23/2012
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