Individual
MRS. MARIE RACKLEY PADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC, EMDR
Contact information
Practice address
1186 FAIRVIEW RD N, CHATHAM, VA 24531-3384
(434) 770-4326
(434) 432-4305
Mailing address
929 DOUBLE BRIDGE RD, CHATHAM, VA 24531-4391
(434) 770-4326
(434) 432-4305
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701007122
VA
101YM0800X
Mental Health Counselor
Primary
0701007122
VA
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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