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Individual

MR. IVAN RESTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
620 COURT ST FL 5, LYNCHBURG, VA 24504-1312
(434) 485-8861
(434) 485-8877
Mailing address
620 COURT ST FL 5, LYNCHBURG, VA 24504-1312
(434) 485-8861
(434) 485-8877

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004928
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1871542340
VA
Enumeration date
02/16/2011
Last updated
02/16/2011
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