Homer Rainey Gillmore LCSW

NPI 1346411311 - Social Worker - 1041C0700X

NPI Details
NPI 1346411311
Gender Male
Enumeration Date 03/18/2008
Last Updated 03/18/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1213 LASKIN RD
SUITE 104
VIRGINIA BEACH VA, 23451-5260, US
Phone (757) 428-6016
Fax
Business Location
5936 COVE LANDING RD
#303
BURKE VA, 22015-4788, US
Phone (703) 250-7365
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Virginia
License Number 0904003386
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According to our database, Mr. Homer Rainey Gillmore LCSW NPI is 1346411311, taxonomy code is 1041C0700X and license number is 0904003386, license state is located at Virginia. Homer Rainey Gillmore LCSW physically located at 1213 Laskin Rd, Virginia Beach VA, 23451-5260. NPI Number Homer Rainey Gillmore LCSW has the Individual type.

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1346411311 NPI number is provided on an as is basis without warranty of any kind. 1346411311 is maintained by the National Plan & Provider Enumeration System. The contents of Homer Rainey Gillmore LCSW are for informational purposes only.