| NPI | 1407744600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PAIGE CUNNINGHAM Owner 757-873-1958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |