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General NPI Number Information
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NPI Number | 1679141972
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Entity Type | Organization
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Legal Business Name | RENEWAL, GROWTH, & HEALING
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 8545 PATTERSON AVE STE 201
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City | HENRICO
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State | VA
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Zip | 23229-6455
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Country | US
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Telephone | 804-901-1570
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Fax | 804-442-7111
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Provider Business Mailing Address
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Address Line | 8545 PATTERSON AVE STE 201
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City | HENRICO
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State | VA
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Zip | 23229-6455
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Country | US
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Telephone | 804-901-1570
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Fax | 804-442-7111
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DREAMEL SPADY
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Credential | LCSW
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Telephone | 804-901-1570
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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 |
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License Number State |
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