| NPI | 1871965277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE GANGE Owner 757-460-4655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024170939) |
| Enumeration Date | 2015-10-24 |
| Last Update Date | 2021-02-05 |