Individual
MR. DONELL BRAXTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
886 CHARLOTTE DR, NEWPORT NEWS, VA 23601-1000
(757) 223-0160
Mailing address
886 CHARLOTTE DR, NEWPORT NEWS, VA 23601-1000
(757) 223-0160
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102541
VA
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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