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General NPI Number Information
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NPI Number | 1831901503
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Entity Type | Individual
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Provider Name | MRS. ANNA JOSEPHINE MEWBOURN
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Gender | Female
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 4216 VIRGINIA BEACH BLVD STE 220
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1297
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Country | US
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Telephone | 757-202-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 401 GREENVIEW DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4466
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Country | US
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Telephone | 906-281-4637
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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 | 0704017620
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License Number State | VA
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