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Organization

EVOLVE THERAPEUTIC COUNSELING SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. VICTOR M MOODY (OWNER)
(757) 224-7986
Entity
Organization

Contact information

Practice address
2021B CUNNINGHAM DR, SUITE 2, HAMPTON, VA 23666-3326
(757) 224-7986
(757) 224-8321
Mailing address
2021B CUNNINGHAM DR, SUITE 2, HAMPTON, VA 23666-3326
(757) 224-7986
(757) 224-8321

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1095-05
VA

Other

Enumeration date
05/04/2010
Last updated
05/04/2010
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