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1275296600
ROBERT TICE
SALEM, VA
NPI
1275296600
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VA 0710103540)
Enumeration Date
2021-10-21
Last Update Date
2021-10-21
Business Address
ROBERT TICE
6461 BRADSHAW RD
SALEM, VA 24153-2223
Phone number: 540-384-6748
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Mailing Address
ROBERT TICE
6461 BRADSHAW RD
SALEM, VA 24153-2223
Phone number: 540-384-6748
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