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General NPI Number Information
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NPI Number | 1720122146
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Entity Type | Organization
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Legal Business Name | NEWMAN AVENUE ASSOCIATES, PC
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 110 NEWMAN AVE
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City | HARRISONBURG
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State | VA
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Zip | 22801-4004
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Country | US
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Telephone | 540-434-2848
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Fax | 540-434-2883
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Provider Business Mailing Address
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Address Line | 110 NEWMAN AVE
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City | HARRISONBURG
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State | VA
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Zip | 22801-4004
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Country | US
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Telephone | 540-434-2848
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Fax | 540-434-2883
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Authorized Official
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Title or Position | PARTNER
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Name | MS. BONITA H JANTZI
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Credential | LCSW
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Telephone | 540-434-2848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 1074
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License Number State | VA
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