Individual
MRS. CORETHA MARIE CLAIBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC,MAC,SAP,LSATP
Contact information
Practice address
700 S. SYCAMORE STREET, SUITE 6, PETERSBURG, VA 23234
(804) 855-8625
Mailing address
7053 OMALLEY DRIVE, RICHMOND, VA 23234
(804) 275-2340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710101777
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0718000231
VA
Other
Enumeration date
02/29/2008
Last updated
03/17/2010
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