| NPI | 1205270147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHARINE W HEATWOLE Md 757-647-0480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2024-05-21 |