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Organization

PAMELA DOUGLAS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA KAVANAUGH DOUGLAS (OWNER)
(804) 282-4000
Entity
Organization

Contact information

Practice address
6722 PATTERSON AVE, SUITE B, RICHMOND, VA 23226-3400
(804) 282-4000
(804) 282-7799
Mailing address
6722 PATTERSON AVE, SUITE B, RICHMOND, VA 23226-3400
(804) 282-4000
(804) 282-7799

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0015000655
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C09408
MEDICARE GROUP NUMBER
VA
Enumeration date
11/19/2007
Last updated
11/19/2007
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