Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 0904001932 | VA |
N | 101YP1600X | Pastoral Counselor | 0904001932 | VA |
NPI | 1356518344 |
---|---|
Provider Name | Mr. Toby Anderson |
First Address | Richmond, VA 23225-1606 |
Second Address | Richmond, VA 23225-1606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2008 |
Last Update Date | 09/05/2008 |