Individual
TAIVIA K STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3300 OLD COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-1411
(804) 317-2526
Mailing address
3300 OLD COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-1411
(804) 317-2526
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
0903002167
VA
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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