| NPI | 1639821572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIA DOTRICE HORTON Owner 757-333-0175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 261QM0801X | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-07-21 |