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General NPI Number Information
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NPI Number | 1568643344
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Entity Type | Individual
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Provider Name | LOREN MICHELLE COBB MFTI
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Gender | Female
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 501 E FRANKLIN ST SUITE 414
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City | RICHMOND
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State | VA
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Zip | 23219-2322
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Country | US
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Telephone | 804-370-5989
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Fax |
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Provider Business Mailing Address
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Address Line | 3420 PUMP RD #213
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City | HENRICO
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State | VA
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Zip | 23233-1111
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Country | US
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Telephone | 804-370-5989
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001311
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT49671
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License Number State | CA
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