NPI | 1083373740 |
---|---|
Doing Business As | SUPREME HEALING PSYCHOLOGICAL SERVICES, PLLC. |
Entity Type | Organization |
Authorized Contact | CHIQUITA COLLINS Provider 757-933-5386 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2021-12-09 |
Last Update Date | 2024-07-08 |