Individual
TINA MRAVCAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 748-1227
(804) 717-6659
Mailing address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 748-1227
(804) 717-6659
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336293000
—
VA
Enumeration date
04/22/2016
Last updated
04/22/2016
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