Individual
TOMAS MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
213 MCCLANAHAN ST SW, ROANOKE, VA 24014-1762
(540) 981-8951
Mailing address
5406 N LAKE DR, ROANOKE, VA 24019-2628
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810-001233
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780650366
—
VA
Enumeration date
02/24/2006
Last updated
06/18/2008
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