Healthcare Provider Details

I. General information

NPI: 1275234460
Provider Name (Legal Business Name): OWNA THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 WATERSIDE DR STE 2525
NORFOLK VA
23510-3316
US

IV. Provider business mailing address

999 WATERSIDE DR STE 2525
NORFOLK VA
23510-3316
US

V. Phone/Fax

Practice location:
  • Phone: 757-304-8801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VEATRICE MAPP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 757-304-8801