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General NPI Number Information
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NPI Number | 1245852433
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Entity Type | Organization
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Legal Business Name | INNER ANCHOR, LLC
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 68 BROOK STONE CT APT 18
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City | GALAX
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State | VA
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Zip | 24333-4285
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Country | US
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Telephone | 276-233-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 68 BROOK STONE CT APT 18
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City | GALAX
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State | VA
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Zip | 24333-4285
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Country | US
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Telephone | 276-233-0478
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | LAURA NICOLE BARNETTE
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Credential | LPC
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Telephone | 276-233-0478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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