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General NPI Number Information
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NPI Number | 1922587625
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Entity Type | Organization
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Legal Business Name | CHRISTINE OGLESBY FAMILY THERAPY PLLC
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 7147 BRANDY HILL TER APT 202
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City | MECHANICSVILLE
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State | VA
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Zip | 23111
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Country | US
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Telephone | 434-515-3510
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Fax |
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Provider Business Mailing Address
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Address Line | 7147 BRANDY HILL TER APT 202
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4499
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Country | US
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Telephone | 434-515-3510
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE ELIXZABETH OGLESBY
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Credential | LPC, LMFT
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Telephone | 434-515-3510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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