| NPI | 1134836653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT JEFFERIES Owner, Provider 540-809-8858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-03 |