Individual
DARCELL LANIER WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1610 GLENDALE ST, HOPEWELL, VA 23860-6922
(804) 312-6883
Mailing address
1610 GLENDALE ST, HOPEWELL, VA 23860-6922
(804) 312-6883
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
3593-01-001
VA
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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