| Mdk Llc | |
|
3111 Northside Ave Ste 101 Henrico VA 23228-5441 | |
| (804) 366-4330 | |
| Not Available |
| Full Name | Mdk Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3111 Northside Ave Ste 101, Henrico, Virginia |
| Authorized Official Name and Position | Monica D Klisz (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 8043664330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdk Llc 3111 Northside Ave Ste 101 Henrico VA 23228-5441 Ph: (804) 366-4330 | Mdk Llc 3111 Northside Ave Ste 101 Henrico VA 23228-5441 Ph: (804) 366-4330 |
| NPI Number | 1346010600 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346010600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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