# BIRD ON A WIRE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760065858
- **Authorized official:** GWENDOLYN ROSE MBUVI LMFT (OWNER)
- **Authorized official phone:** (804) 413-9037

## Contact information

- **Practice address:** 15 RESEARCH DRIVE, SUITE A, HAMPTON, VA 23666
- **Practice address phone:** (804) 413-9037
- **Practice address fax:** (757) 852-0475
- **Mailing address:** 5007C VICTORY BLVD \# 177, YORKTOWN, VA 23693-5601
- **Mailing address phone:** (804) 413-9037
- **Mailing address fax:** (757) 852-0475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2021
- **Last updated:** 12/15/2023