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General NPI Number Information
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NPI Number | 1164226908
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Entity Type | Organization
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Legal Business Name | ANNA MARIE
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 10703 GAYTON RD
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City | HENRICO
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State | VA
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Zip | 23238-4118
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Country | US
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Telephone | 804-396-8566
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Fax | 804-396-8566
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Provider Business Mailing Address
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Address Line | 9619 QUIOCCASIN RD
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City | HENRICO
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State | VA
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Zip | 23238-4524
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Country | US
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Telephone | 804-922-7712
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Fax | 804-922-7712
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Authorized Official
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Title or Position | PUBLIC HEALTH CONSULTANT
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Name | PHOEBE OGUDA DACHA
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Credential |
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Telephone | 804-396-8566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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