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General NPI Number Information
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NPI Number | 1558025023
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Entity Type | Organization
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Legal Business Name | MENTAL SWELLNESS
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 5037 HALIFAX RD STE U4
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City | HALIFAX
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State | VA
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Zip | 24558-3243
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Country | US
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Telephone | 434-303-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 490 BUENA VISTA DR
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City | HALIFAX
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State | VA
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Zip | 24558-2152
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Country | US
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Telephone | 973-769-5681
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | MEGAN J ZAMORA
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Credential | NP
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Telephone | 434-303-2300
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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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