Healthcare Provider Details

I. General information

NPI: 1346988698
Provider Name (Legal Business Name): MRS. RACHELLE MARIE NGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 PROFESSIONAL RD STE A
NORTH CHESTERFIELD VA
23235-3267
US

IV. Provider business mailing address

2520 PROFESSIONAL RD STE A
NORTH CHESTERFIELD VA
23235-3267
US

V. Phone/Fax

Practice location:
  • Phone: 804-324-3331
  • Fax:
Mailing address:
  • Phone: 804-324-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904014031
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: