| NPI | 1649049040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH BRAXTON Owner 804-878-3518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2025-06-13 |