| Miracle Miles Mental Health | |
|
5841 Snead Rd Richmond VA 23224-4661 | |
| (804) 688-9777 | |
| Not Available |
| Full Name | Miracle Miles Mental Health |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 5841 Snead Rd, Richmond, Virginia |
| Authorized Official Name and Position | Tonjanika Ballard (BUSINESS CONSULTANT) |
| Authorized Official Contact | 8044418538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Miles Mental Health 5841 Snead Rd Richmond VA 23224-4661 Ph: (804) 688-9777 | Miracle Miles Mental Health 5841 Snead Rd Richmond VA 23224-4661 Ph: (804) 688-9777 |
| NPI Number | 1700600665 |
|---|---|
| Provider Enumeration Date | 11/08/2024 |
| Last Update Date | 11/08/2024 |
| Certification Date | 11/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700600665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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