Individual
EDITH G MOORCONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
760 PILOT HOUSE DR STE E, NEWPORT NEWS, VA 23606-2068
(757) 595-3455
(757) 595-3456
Mailing address
760 PILOT HOUSE DR STE E, NEWPORT NEWS, VA 23606-2068
(757) 595-3455
(757) 595-3456
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003899
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904003899
MEDICAL STATE LICENSE
VA
Enumeration date
09/20/2022
Last updated
09/22/2022
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