Healthcare Provider Details
I. General information
NPI: 1902054935
Provider Name (Legal Business Name): RICHMOND THERAPY CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/03/2008
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 COALFIELD RD
MIDLOTHIAN VA
23114-4403
US
IV. Provider business mailing address
400 COALFIELD RD
MIDLOTHIAN VA
23114-4403
US
V. Phone/Fax
- Phone: 804-897-7440
- Fax: 804-897-7441
- Phone: 804-897-7440
- Fax: 804-897-7441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 0119000956 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 2202005085 |
| License Number State | VA |
VIII. Authorized Official
Name:
KAYLA
MAY
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 804-897-7440