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General NPI Number Information
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NPI Number | 1659719656
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Entity Type | Organization
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Legal Business Name | SALIMAH'S HOUSE INC
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 13305 OLD BARN CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4874
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Country | US
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Telephone | 804-551-7363
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Fax |
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Provider Business Mailing Address
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Address Line | 13305 OLD BARN CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4874
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Country | US
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Telephone | 804-551-7363
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KHIDHRA S SMITH
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Credential | LCSW
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Telephone | 804-551-7363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007802
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License Number State | VA
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