Provider Demographics
NPI:1861516940
Name:RICHMOND IOP, PLC
Entity type:Organization
Organization Name:RICHMOND IOP, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SANTARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP, NCC
Authorized Official - Phone:804-320-8032
Mailing Address - Street 1:10049 MIDLOTHIAN TPKE
Mailing Address - Street 2:SUITE B2
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4859
Mailing Address - Country:US
Mailing Address - Phone:804-320-8032
Mailing Address - Fax:804-323-0602
Practice Address - Street 1:10049 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE B2
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4859
Practice Address - Country:US
Practice Address - Phone:804-320-8032
Practice Address - Fax:804-323-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA580174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty