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Organization
SANCTYOUARY
Active
Organization
SANCTYOUARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEIMISHIA HOLLOWAY RN (REGISTERD NURSE)
(757) 749-8507
Entity
Organization
Contact information
Practice address
900 COMMONWEALTH PL STE 2001020, VIRGINIA BEACH, VA 23464-4517
(757) 749-8507
Mailing address
900 COMMONWEALTH PL STE 2001020, VIRGINIA BEACH, VA 23464-4517
(757) 749-8507
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
10/30/2023
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