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General NPI Number Information
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NPI Number | 1649568544
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Entity Type | Organization
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Legal Business Name | PULLIAM INNOVATIVE CONSULTING FIRM
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 1801 E BROAD ST SUITE C
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City | RICHMOND
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State | VA
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Zip | 23223-6974
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Country | US
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Telephone | 804-385-4171
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 E. BROAD ST. SUITE C
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City | RICHMOND
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State | VA
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Zip | 23223-7272
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Country | US
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Telephone | 804-385-4171
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. TONYA LANEKA PULLIAM
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Credential | MSW
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Telephone | 804-385-4171
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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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