| NPI | 1235902438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PHELPS Owner 703-283-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2025-03-28 |