| Laurie Shea | |
|
120 Ponderosa Dr Suite D Christiansburg VA 24073-6598 | |
| (540) 382-1494 | |
| (540) 344-7154 |
| Full Name | Laurie Shea |
|---|---|
| Speciality | Counselor |
| Location | 120 Ponderosa Dr, Christiansburg, Virginia |
| Authorized Official Name and Position | Laurie Shea (OWNER) |
| Authorized Official Contact | 5403821494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurie Shea Po Box 4127 Roanoke VA 24015-0127 Ph: (540) 981-9394 | Laurie Shea 120 Ponderosa Dr Suite D Christiansburg VA 24073-6598 Ph: (540) 382-1494 |
| NPI Number | 1871768838 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 06/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871768838 | NPI | - | NPPES |
| 1821036153 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 07010013044 (Virginia) | Primary |
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