| Elton's Soul To Soul Company | |
|
3247 Electric Rd Ste 1a Roanoke VA 24018-6448 | |
| (540) 772-0690 | |
| (540) 772-0692 |
| Full Name | Elton's Soul To Soul Company |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3247 Electric Rd Ste 1a, Roanoke, Virginia |
| Authorized Official Name and Position | Nicole Carpenter Elton (PROVIDER) |
| Authorized Official Contact | 5403532244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elton's Soul To Soul Company 6776 Hidden Woods Dr Roanoke VA 24018-7480 Ph: (540) 353-2244 | Elton's Soul To Soul Company 3247 Electric Rd Ste 1a Roanoke VA 24018-6448 Ph: (540) 772-0690 |
| NPI Number | 1104465129 |
|---|---|
| Provider Enumeration Date | 12/23/2019 |
| Last Update Date | 12/23/2019 |
| Certification Date | 12/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104465129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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