Individual
MRS. COURTNI BROOKE SANDRAS-GAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
402 CAMPBELL AVE SW, ROANOKE, VA 24016-3627
(540) 400-7431
(540) 400-7091
Mailing address
PO BOX 541, ROANOKE, VA 24003-0541
(540) 400-7431
(540) 400-7091
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010061
VA
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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