Individual
MIRIAM RUTH BOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6802 PARAGON PL STE 525, RICHMOND, VA 23230-1659
(804) 592-6363
Mailing address
3303 BARTON AVE, RICHMOND, VA 23222-2707
(616) 617-2906
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701008507
VA
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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