COREY ISAIAH PURNELL

ANNANDALE, VA
NPI1508615204
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VA  0709025467)
Enumeration Date2024-05-15
Last Update Date2024-05-15
Business Address
COREY ISAIAH PURNELL CSAC Supervisee
5105Q BACKLICK RD
ANNANDALE, VA 22003-6072
Phone number: 571-517-2430
Mailing Address
COREY ISAIAH PURNELL CSAC Supervisee
10736 MAPLE ST
FAIRFAX, VA 22030-5122
Phone number: 757-358-8250
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