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Individual

MRS. LAURA SHIBUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4112 INNSLAKE DR, GLEN ALLEN, VA 23060-3344
(703) 534-5100
Mailing address
4112 INNSLAKE DR, GLEN ALLEN, VA 23060-3344
(703) 534-5100

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704018051
VA

Other

Enumeration date
06/03/2025
Last updated
06/03/2025
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