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General NPI Number Information
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NPI Number | 1255293940
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Entity Type | Organization
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Legal Business Name | LARKSPUR WELLNESS, PLLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2200 COLONIAL AVE STE 11
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City | NORFOLK
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State | VA
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Zip | 23517-1919
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Country | US
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Telephone | 757-520-5102
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Fax | 757-760-7783
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Provider Business Mailing Address
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Address Line | 2200 COLONIAL AVE STE 11
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City | NORFOLK
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State | VA
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Zip | 23517-1919
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Country | US
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Telephone | 757-520-5102
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Fax | 757-760-7783
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Authorized Official
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Title or Position | OWNER
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Name | KATRINA SAMBORSKI
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Credential | PMHNP
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Telephone | 757-520-5102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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