Healthcare Provider Details
I. General information
NPI: 1396104410
Provider Name (Legal Business Name): MAMA REES CHILD DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/17/2016
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4501 WILLIAMSBURG RD STE L
RICHMOND VA
23231-2748
US
IV. Provider business mailing address
4501 WILLIAMSBURG RD STE L
RICHMOND VA
23231-2748
US
V. Phone/Fax
- Phone: 804-222-1648
- Fax:
- Phone: 804-222-1648
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225600000X |
| Taxonomy | Dance Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHEREE
SNEAD
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 12024137545