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General NPI Number Information
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NPI Number | 1740557099
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Entity Type | Individual
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Provider Name | ANGELA BACH
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Gender | Female
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 08/01/2014
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Provider Practice Location Address
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Address Line | 3111 NORTHSIDE AVE SUITE 101
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City | RICHMOND
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State | VA
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Zip | 23228-5441
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Country | US
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Telephone | 804-840-6176
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Fax | 804-272-1571
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Provider Business Mailing Address
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Address Line | 3600 MERIDALE RD
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City | RICHMOND
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State | VA
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Zip | 23225-1145
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Country | US
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Telephone | 804-840-6176
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Fax | 804-272-1571
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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 | 0701001567
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License Number State | VA
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