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1407331135
DEMEITRIUS M WHITEHURST
NORFOLK, VA
NPI
1407331135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VA 0710102215)
Enumeration Date
2018-09-27
Last Update Date
2018-09-27
Business Address
DEMEITRIUS M WHITEHURST B.A., CSAC, QMHP-A-C
12388 WARWICK BLVD STE 302, NEWPORT NEWS, VA 23602 STE 302
NORFOLK, VA 23606-2360
Phone number: 757-679-6058
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Mailing Address
DEMEITRIUS M WHITEHURST B.A., CSAC, QMHP-A-C
12388 WARWICK BLVD STE 302
NEWPORT NEWS, VA 23606-3858
Phone number: 757-679-6058
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