Individual
LASTARR WOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 E BROAD ST STE 42, RICHMOND, VA 23219-1737
(804) 475-8324
Mailing address
313 E BROAD ST STE 42, RICHMOND, VA 23219-1737
(804) 475-8324
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5249
VA
101YP2500X
Professional Counselor
5249
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-4321733
—
VA
Enumeration date
12/06/2022
Last updated
12/06/2022
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