Individual
MATTHEW DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
508 LIBBIE AVE, RICHMOND, VA 23226-2618
(434) 202-4080
Mailing address
508 LIBBIE AVE, RICHMOND, VA 23226-2618
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704016253
VA
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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