Organization
NOVA HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHIDHRA S POOLE DSW, LCSW (CEO)
(804) 601-0042
Entity
Organization
Contact information
Practice address
13305 OLD BARN CT, MIDLOTHIAN, VA 23112-4874
(804) 601-0042
(804) 706-1640
Mailing address
13305 OLD BARN CT, MIDLOTHIAN, VA 23112-4874
(804) 601-0042
(804) 706-1640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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