| NPI | 1558989475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN L JAREK Psychiatric Nurse Practitioner 757-310-8167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2024-08-28 |