| NPI | 1154168102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE AKHOASEGBE EHICHIOYA Owner 703-973-0176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-12-18 |