| NPI | 1104785104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ANTWI-KISSEADOO Owner 804-497-9794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-01-16 |
| Last Update Date | 2026-01-16 |