| NPI | 1003623067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGINA COCA Owner/Authorize Official 703-598-4115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2024-12-13 |