| NPI | 1053149211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELITA WILSON PRIMUS President 804-470-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-12-12 |