Individual
KAREN LOIS MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5505 INDIAN RIVER RD STE 100, VIRGINIA BEACH, VA 23464-5252
(757) 472-4982
Mailing address
5505 INDIAN RIVER RD STE 100, VIRGINIA BEACH, VA 23464-5252
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701007573
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701007573
LICENSED PROFESSIONAL COUNSELOR
VA
Enumeration date
03/29/2018
Last updated
03/29/2018
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