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General NPI Number Information
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NPI Number | 1609340975
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Entity Type | Organization
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Legal Business Name | AZZ-ERT URSELF INC
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Dates
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Enumeration Date | 01/19/2019
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 900 COMMONWEALTH PL STE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4517
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Country | US
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Telephone | 256-639-4464
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Fax | 757-782-9003
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Provider Business Mailing Address
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Address Line | 900 COMMONWEALTH PL STE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4517
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Country | US
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Telephone | 256-639-4464
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Fax | 757-782-9003
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Authorized Official
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Title or Position | THERAPIST/CEO
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Name | DANITA MORALES RAMOS
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Credential | LPC
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Telephone | 256-639-4464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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