Individual
LAVALLE MCINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2663 OSBORNE RD, CHESTER, VA 23831-2168
(804) 882-3606
Mailing address
1706 ANCHOR LANDING DR, CHESTER, VA 23836-5412
(804) 882-3605
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701007039
VA
Other
Enumeration date
03/13/2017
Last updated
10/11/2024
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