Provider Demographics
NPI:1407996705
Name:PRICE, VIRGINA L (MH REHAB SPEC)
Entity Type:Individual
Prefix:
First Name:VIRGINA
Middle Name:L
Last Name:PRICE
Suffix:
Gender:F
Credentials:MH REHAB SPEC
Other - Prefix:
Other - First Name:VIRGINA
Other - Middle Name:L
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9860 MIDDLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:UPPER LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95485-9265
Mailing Address - Country:US
Mailing Address - Phone:707-275-8166
Mailing Address - Fax:
Practice Address - Street 1:9860 MIDDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:UPPER LAKE
Practice Address - State:CA
Practice Address - Zip Code:95485-9265
Practice Address - Country:US
Practice Address - Phone:707-275-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor