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General NPI Number Information
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NPI Number | 1831648583
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Entity Type | Organization
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Legal Business Name | Z. ANDREW JATAU MS, LPC LLC
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 328 OFFICE SQUARE LN SUITE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3648
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Country | US
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Telephone | 757-559-1773
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Fax |
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Provider Business Mailing Address
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Address Line | 328 OFFICE SQUARE LN SUITE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3648
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Country | US
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Telephone | 757-559-1773
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ZAMWAWOSAYI ANDREW JATAU
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Credential | MS, LPC
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Telephone | 757-620-8539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0701005514
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License Number State | VA
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