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1316350465
LASHONDREA NIXON
PETERSBURG, VA
NPI
1316350465
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: VA 2133)
Enumeration Date
2014-06-06
Last Update Date
2014-06-06
Business Address
-- LASHONDREA NIXON
20 E TABB ST 207
PETERSBURG, VA 23803-4541
Phone number: 336-575-7310
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Mailing Address
-- LASHONDREA NIXON
722 IVY GLEN DR
WINSTON SALEM, NC 27127-4065
Phone number:
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