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General NPI Number Information
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NPI Number | 1710593447
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Entity Type | Individual
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Provider Name | KENDRA ANISSA ARTIS RES IN COUNSELING
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Gender | Female
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 5005 AMBOY COURT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6028
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Country | US
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Telephone | 757-318-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 5005 AMBOY CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4234
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Country | US
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Telephone | 757-232-7009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0701012295
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License Number State | VA
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