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NPI Code Detail

MEDICARE: VISION IN ACTION LLC

MEDICARE: VISION IN ACTION LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2103T00000XPsychologist
3104100000XSocial Worker
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1932614542
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISION IN ACTION LLC
Provider Business Mailing Address
First Line : 701 KENMORE AVE STE 105
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-5792
Country : US
Telephone Number : 540-322-5424
Fax Number :
Provider Business Practice Location Address
First Line : 701 KENMORE AVE STE 105
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-5792
Country : US
Telephone Number : 540-322-5424
Fax Number :
Authorized Official
Title or Position : OWNER
Name : COLETTE BROOKS
Credential :
Telephone Number : 540-322-5424
Provider Enumeration Date : 12/05/2017
Last Update Date : 10/01/2020

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Directions to “VISION IN ACTION LLC ” Practice Location

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