Organization
DIVA,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA CLARK LPC (OWNER)
(540) 446-9877
Entity
Organization
Contact information
Practice address
1024 CENTER BROOKE LANE, F427, SUFFOLK, VA 23434
(540) 446-9877
(866) 743-5703
Mailing address
1024 CENTER BROOKE LANE, F427, SUFFOLK, VA 23434
(540) 446-9877
(866) 743-5703
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/01/2024
Last updated
11/01/2024
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