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Individual

PHYLLIS DENISE PAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
315 HOSPITAL DR STE 204A, MARTINSVILLE, VA 24112-1927
(276) 340-9136
Mailing address
164 HOWARD DR, MARTINSVILLE, VA 24112-8049
(276) 340-9136

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0732004950
VA
172A00000X
Driver
T63352202
VA

Other

Enumeration date
11/01/2019
Last updated
11/01/2019
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