| NPI | 1992442859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELAINA KUZEMKA KUPKA Office Manager 540-546-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2024-05-30 |