| Nova Terra Therapy Plc | |
|
5213a Lyngate Ct Burke VA 22015-1698 | |
| (703) 868-8609 | |
| Not Available |
| Full Name | Nova Terra Therapy Plc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5213a Lyngate Ct, Burke, Virginia |
| Authorized Official Name and Position | Elizabeth Brokamp (FOUNDER) |
| Authorized Official Contact | 7038688609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Terra Therapy Plc 7807 S Valley Dr Fairfax Station VA 22039-2971 Ph: (703) 868-8609 | Nova Terra Therapy Plc 5213a Lyngate Ct Burke VA 22015-1698 Ph: (703) 868-8609 |
| NPI Number | 1992337141 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 02/06/2020 |
| Certification Date | 02/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992337141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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