Individual
JAIMIE ECHTERNACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 MCDOWELL AVE NW, ROANOKE, VA 24016-1225
(540) 266-9200
Mailing address
301 ELM AVE SW, ROANOKE, VA 24016-4001
(540) 345-9841
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009744
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437137734
—
VA
Enumeration date
01/24/2017
Last updated
01/24/2017
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