Healthcare Provider Details

I. General information

NPI: 1366277246
Provider Name (Legal Business Name): KUIYIN REBECCA HOCHOY CARTER M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PLEASANTS LN
PETERSBURG VA
23803-4602
US

IV. Provider business mailing address

100 PLEASANTS LN
PETERSBURG VA
23803-4602
US

V. Phone/Fax

Practice location:
  • Phone: 804-862-7012
  • Fax: 804-861-2197
Mailing address:
  • Phone: 804-862-7012
  • Fax: 804-861-2197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPGP-0670859
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: