Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | VA |
NPI | 1003313016 |
---|---|
Provider Name | Catherine Desaussure Ogletree |
First Address | Midlothian, VA 23112-3994 |
Second Address | Midlothian, VA 23112-3994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2018 |
Last Update Date | 07/04/2018 |