Revercomb, Angela L

Revercomb, Angela L is an sole proprietor health care provider with primary practice located at 3111 Northside Ave Ste 375 , Henrico VA 23228-5441. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Revercomb, Angela L can be contacted via phone (804) 229-3172.

Contact Information

Primary practice address
3111 Northside Ave Ste 375 Henrico VA 23228-5441
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 071003714

Profile Details

NPI number 1700057825
LBN Legal business name Revercomb, Angela L
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 17th, 2008
Last updated Nov 11th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1700057825 NPPES
Virginia MEDICAID 1104858653

Popular Providers