| NPI | 1790466464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BOWERS Pmhnp 757-788-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |