Individual
AMANDA B COULBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
8500 MAYLAND DR STE 200, HENRICO, VA 23294-4700
(804) 214-6699
Mailing address
8500 MAYLAND DR STE 200, HENRICO, VA 23294-4700
(804) 214-6699
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012047
VA
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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