Individual
MISS LARA MARCIE RAE NIMETY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC/ MHSP
Contact information
Practice address
622 POWELL AVE, BIG STONE GAP, VA 24219
(276) 523-0682
(276) 523-0684
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701007832
VA
Other
Enumeration date
03/20/2007
Last updated
12/17/2024
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