Aunt Gwen's Place, LLC

NPI #1518221332 in Lynchburg, Virginia

Provider Information

NPI Number: 1518221332
Entity Type: Organization
Organization Name: Aunt Gwen's Place, LLC
Primary Specialty: Counselor
Enumeration Date: Jun 26, 2012
Last Updated: Jun 26, 2012

Practice Location

Address: 147 MILL RIDGE RD
Address 2: SUITE 131
City: Lynchburg
State: Virginia
ZIP Code: 24502-4341
Phone: (434) 944-4782

Authorized Official

Name: DASHIA WOMACK
Title: OWNER/EXECUTIVE DIRECTOR
Phone: (434) 944-4782

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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