| NPI | 1982097184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA GILBERT GOMES Owner 757-320-4482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024170504) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2020-12-19 |