Mountain Laurel Group, LLC

NPI #1548587405 in Culpeper, Virginia

Provider Information

NPI Number: 1548587405
Entity Type: Organization
Organization Name: Mountain Laurel Group, LLC
Primary Specialty: Counselor - Professional
Enumeration Date: Apr 30, 2010
Last Updated: Jan 26, 2012

Practice Location

Address: 102 N MAIN ST STE 300
City: Culpeper
State: Virginia
ZIP Code: 22701-3053
Phone: (540) 829-1789

Authorized Official

Name: BRUCE C. WYMAN, EDM.,NCC,LPC
Title: CEO/ DIRECTOR
Phone: (540) 829-1789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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