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General NPI Number Information
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NPI Number | 1194468421
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Entity Type | Individual
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Provider Name | MAYA BIRDEN LRIC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 1228 PROGRESSIVE DR STE 201
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2846
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Country | US
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Telephone | 757-436-5601
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Fax | 855-410-0727
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Provider Business Mailing Address
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Address Line | 4949 PAINE LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-5215
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Country | US
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Telephone | 540-656-8098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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