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1700981396
LACONDA GERTRUDE FANNING
HAMPTON, VA
NPI
1700981396
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: VA 0701003750)
Enumeration Date
2006-09-14
Last Update Date
2009-02-04
Business Address
Mrs. LACONDA GERTRUDE FANNING Psy,D, LPC
600 MEDICAL DR SUITE A & B
HAMPTON, VA 23666-1769
Phone number: 757-788-0600
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Mailing Address
Mrs. LACONDA GERTRUDE FANNING Psy,D, LPC
300 MEDICAL DR 2ND FLOOR
HAMPTON, VA 23666-1765
Phone number: 757-788-0300
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