| Penelope Donovan, Llc | |
|
4582 Southland Ave Alexandria VA 22312-1620 | |
| (157) 140-6707 | |
| Not Available |
| Full Name | Penelope Donovan, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4582 Southland Ave, Alexandria, Virginia |
| Authorized Official Name and Position | Penelope Donovan (PRACTICE OWNER) |
| Authorized Official Contact | 5714067079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penelope Donovan, Llc 4582 Southland Ave Alexandria VA 22312-1620 Ph: (571) 406-7079 | Penelope Donovan, Llc 4582 Southland Ave Alexandria VA 22312-1620 Ph: (157) 140-6707 |
| NPI Number | 1417605072 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 03/14/2022 |
| Certification Date | 03/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417605072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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