Wellborn, William

Wellborn, William is an individual health care provider with primary practice located at 3 Riverside Cir , Roanoke VA 24016-4955. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wellborn, William can be contacted via phone (540) 526-1364.

Contact Information

Primary practice address
3 Riverside Cir Roanoke VA 24016-4955
Phone: (540) 526-1364
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810-002556 Virginia

Profile Details

NPI number 1467432450
LBN Legal business name Wellborn, William
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Oct 18th, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467432450 NPPES
Virginia MEDICAID 7709129

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