| NPI | 1598861387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT VELASQUEZ Practice Administrator 757-937-3969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2025-03-17 |