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Individual

BRUCE A LOUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15607 CHESDIN MANOR DR, CHESTERFIELD, VA 23838-4520
(360) 485-6212
(804) 451-9078
Mailing address
PO BOX 1704, CHESTERFIELD, VA 23832-9107
(360) 485-6212
(804) 451-9078

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
60809541
WA

Other

Enumeration date
08/13/2020
Last updated
01/21/2022
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