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DR. ROGER LEE MACE D.MIN.

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1386843274

Individual Registrant:
DR. ROGER LEE MACE D.MIN.
Gender: M
Sole Proprietor

Location and contact information for practice:
13491 PORT REPUBLIC RD  GROTTOES, VA 24441-5216 US
Tel: 540-249-3780  Fax: 540-249-3780

Contact information for business:
13491 PORT REPUBLIC RD  GROTTOES, VA 24441-5216 US
Tel: 540-249-3780  Fax: 540-249-3780

Registration Information:
NPI: 1386843274
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
VA0717000360

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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