Individual
TINA VANBUREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
368 BARGER DR, EAGLE ROCK, VA 24085-3551
(540) 676-2047
Mailing address
368 BARGER DR, EAGLE ROCK, VA 24085-3551
(540) 676-2047
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/30/2015
Last updated
01/04/2018
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