Individual
ELIZABETH WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2900 TYLER RD, CHRISTIANSBURG, VA 24073-6374
(540) 731-7311
Mailing address
113 CANTERBURY CT, BLACKSBURG, VA 24060-3822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904-000753
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010195497
—
VA
05
—
8931208
—
VA
Enumeration date
03/17/2006
Last updated
06/13/2008
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