Provider Demographics
NPI:1922310366
Name:STRAWDERMAN, GEORGENA H
Entity Type:Individual
Prefix:
First Name:GEORGENA
Middle Name:H
Last Name:STRAWDERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 RAMOTH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-4518
Mailing Address - Country:US
Mailing Address - Phone:540-657-6737
Mailing Address - Fax:
Practice Address - Street 1:932 RAMOTH CHURCH RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22406-4518
Practice Address - Country:US
Practice Address - Phone:540-657-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator