Provider Information for 1821705054
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DESIREE LIPSCOMB LPC
Sex: Female
NPI: 1821705054
Last Updated: 2022-10-27
Certification Date: 2022-10-10
Certification Date: 2022-10-10
Details
| Name | Value | ||||||||
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| NPI | 1821705054 | ||||||||
| Enumeration Date | 2022-10-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 10314 CRUMPETS LN NORTH CHESTERFIELD, VA 23235-3822 United States Phone: 434-579-5037 | Fax: | ||||||||
| Primary Practice Address | 6910 COURTHOUSE RD CHESTERFIELD, VA 23832-5309 United States Phone: 804-796-4225 | Fax: | ||||||||
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