| Smoke 04/04 | |
|
6801 Kennedy Rd Warrenton VA 20187-3995 | |
| (324) 324-3434 | |
| Not Available |
| Full Name | Smoke 04/04 |
|---|---|
| Speciality | Psychologist |
| Location | 6801 Kennedy Rd, Warrenton, Virginia |
| Authorized Official Name and Position | Test Org-a (ADMIN) |
| Authorized Official Contact | 5551112222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smoke 04/04 7281 4th St Remington VA 22734-2124 Ph: () - | Smoke 04/04 6801 Kennedy Rd Warrenton VA 20187-3995 Ph: (324) 324-3434 |
| NPI Number | 1952095135 |
|---|---|
| Provider Enumeration Date | 07/30/2014 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952095135 | NPI | - | NPPES |
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