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General NPI Number Information
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NPI Number | 1235880766
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Entity Type | Organization
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Legal Business Name | ON THE MARK PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 216 E MAIN ST
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City | RICHMOND
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State | VA
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Zip | 23219-3715
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Country | US
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Telephone | 804-878-3518
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Fax | 651-855-5083
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Provider Business Mailing Address
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Address Line | 216 E MAIN ST
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City | RICHMOND
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State | VA
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Zip | 23219-3715
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Country | US
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Telephone | 804-878-3518
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Fax | 651-855-5083
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. HANNAH MARKS BRAXTON
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Credential | NP
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Telephone | 804-878-3518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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