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
Phone: (804) 229-3172
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700057825 | NPPES |
| Virginia | MEDICAID | 1104858653 |
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