Individual
DEBORAH GOODRICH COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
26317 WEST WASHINGTON STREET, PETERSBURG, VA 23803-0030
(804) 524-7346
(804) 524-4718
Mailing address
9012 CIRCLEWOOD DR, PETERSBURG, VA 23803-7746
(804) 524-7346
(804) 524-4718
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230004347
VA
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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