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General NPI Number Information
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NPI Number | 1699349514
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Entity Type | Individual
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Provider Name | AMBER LYNETTE SHREVE
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Gender | Female
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Dates
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Enumeration Date | 05/15/2021
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Last Update Date | 05/15/2021
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Provider Practice Location Address
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Address Line | 31494 CHAMPS DR
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City | FRANKLIN
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State | VA
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Zip | 23851-3839
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Country | US
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Telephone | 757-319-2273
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Fax | 757-606-9606
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Provider Business Mailing Address
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Address Line | PO BOX 1287
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City | FRANKLIN
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State | VA
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Zip | 23851-9666
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Country | US
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Telephone | 757-319-2273
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Fax | 757-606-9606
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701010502
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License Number State | VA
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