Healthcare Provider Details

I. General information

NPI: 1992931752
Provider Name (Legal Business Name): JANICE TOOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 06/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6962 FOREST HILL AVE
RICHMOND VA
23225-1606
US

IV. Provider business mailing address

6962 FOREST HILL AVE
RICHMOND VA
23225-1606
US

V. Phone/Fax

Practice location:
  • Phone: 804-320-7738
  • Fax: 804-320-8738
Mailing address:
  • Phone: 804-320-7738
  • Fax: 804-320-8738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0903001677
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: