| NPI | 1770398109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CONWAY Nurse Practitioner 757-377-5559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2025-02-12 |