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Organization
VICTORIA HEALTH AND WELLNESS LLC
Active
Organization
VICTORIA HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLAMIDE VINCENT CRNP (NURSE PRACTITIONER)
(484) 340-9768
Entity
Organization
Contact information
Practice address
2502 SILVERSIDE RD STE 6, WILMINGTON, DE 19810-3740
(484) 340-9768
Mailing address
990 FERNHILL RD UNIT 632, WEST CHESTER, PA 19380-4288
(484) 340-9768
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/25/2022
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