| Authentic Self Association Llc | |
|
4404 Eaglebrook Dr Williamsburg VA 23188-8038 | |
| (757) 918-3381 | |
| Not Available |
| Full Name | Authentic Self Association Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4404 Eaglebrook Dr, Williamsburg, Virginia |
| Authorized Official Name and Position | Coty A Mills (OWNER/THERAPIST) |
| Authorized Official Contact | 7579183381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Self Association Llc 4404 Eaglebrook Dr Williamsburg VA 23188-8038 Ph: (757) 918-3381 | Authentic Self Association Llc 4404 Eaglebrook Dr Williamsburg VA 23188-8038 Ph: (757) 918-3381 |
| NPI Number | 1720854466 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720854466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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