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1245955731
DAVID SOUTHALL
ROANOKE, VA
NPI
1245955731
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: VA 0701011817)
Enumeration Date
2022-10-06
Last Update Date
2022-10-06
Business Address
DAVID SOUTHALL LPC
3807 BRANDON AVE SW # 1115
ROANOKE, VA 24018-1490
Phone number: 540-342-1261
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Mailing Address
DAVID SOUTHALL LPC
3807 BRANDON AVE SW # 1115
ROANOKE, VA 24018-1490
Phone number: 540-342-1261
Copy
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