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Individual

JACTON ONYANGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, CSAC

Contact information

Practice address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
Mailing address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710000525
VA
101YM0800X
Mental Health Counselor
Primary
0701004654
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4945255
VA
Enumeration date
02/03/2010
Last updated
02/03/2010
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