| NPI | 1972387892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETITECHA WIMBUSH Psychiatric Nurse Practitioner/CEO 804-234-4893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2024-06-11 |