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Individual

IAN DEMODNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A. COUNSELING

Contact information

Practice address
1001 RICHMOND RD, WILLIAMSBURG, VA 23185-2895
(757) 784-8790
(757) 208-0829
Mailing address
1001 RICHMOND RD, WILLIAMSBURG, VA 23185-2895
(757) 784-8790
(757) 208-0829

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
01/26/2017
Last updated
01/26/2017
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