Healthcare Provider Details

I. General information

NPI: 1164830394
Provider Name (Legal Business Name): INFINITY CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 POINDEXTER ST
CHESAPEAKE VA
23324-2426
US

IV. Provider business mailing address

1205 POINDEXTER ST
CHESAPEAKE VA
23324-2426
US

V. Phone/Fax

Practice location:
  • Phone: 188-866-0441
  • Fax:
Mailing address:
  • Phone: 188-866-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPPS-0603422
License Number StateVA

VIII. Authorized Official

Name: CYNTHIA YEVETTE DAVIS
Title or Position: OWNER COUNSELOR
Credential: M. ED.
Phone: 757-802-8058