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General NPI Number Information
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NPI Number | 1750908034
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Entity Type | Organization
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Legal Business Name | VOLTAIRE BEHAVIORAL HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 1200 G ST NW STE 800
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City | WASHINGTON
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State | DC
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Zip | 20005-6705
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Country | US
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Telephone | 202-743-1955
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Fax | 773-373-0296
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Provider Business Mailing Address
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Address Line | 6806 RUSKIN ST
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City | SPRINGFIELD
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State | VA
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Zip | 22150-2041
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Country | US
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Telephone | 850-544-1414
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Fax | 773-373-0296
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Authorized Official
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Title or Position | CEO
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Name | MRS. MARLAINE REGISTE
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Credential | NURSE PRACTITIONER
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Telephone | 850-544-1414
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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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