| Diva,llc | |
|
1024 Center Brooke Lane F427 Suffolk VA 23434 | |
| (540) 446-9877 | |
| (866) 743-5703 |
| Full Name | Diva,llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1024 Center Brooke Lane, Suffolk, Virginia |
| Authorized Official Name and Position | Patricia Clark (OWNER) |
| Authorized Official Contact | 5404469877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diva,llc 1024 Center Brooke Lane F427 Suffolk VA 23434 Ph: (540) 446-9877 | Diva,llc 1024 Center Brooke Lane F427 Suffolk VA 23434 Ph: (540) 446-9877 |
| NPI Number | 1992528715 |
|---|---|
| Provider Enumeration Date | 11/01/2024 |
| Last Update Date | 11/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992528715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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