Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701009072 | VA |
NPI | 1003439043 |
---|---|
Provider Name | Ms. Mary Francis |
First Address | Roanoke, VA 24014-5156 |
Second Address | Roanoke, VA 24014-5156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2020 |
Last Update Date | 26/05/2020 |