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Organization

COMMUNITY INTERVENTION GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAKEISHA BRANCH (DIRECTOR)
(804) 715-7022
Entity
Organization

Contact information

Practice address
205A TEMPLE AVE, COLONIAL HEIGHTS, VA 23834-2827
(804) 715-7022
Mailing address
5700 FOX HUNT TRL, SOUTH CHESTERFIELD, VA 23803-2284
(804) 715-7022

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary

Other

Enumeration date
06/15/2021
Last updated
06/15/2021
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