Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701007640 | VA |
NPI | 1982282729 |
---|---|
Provider Name | Lisa Price |
First Address | Martinsville, VA 24112-2810 |
Second Address | Martinsville, VA 24112-2810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2021 |
Last Update Date | 01/04/2021 |