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Organization
ETHOS LEADERSHIP PROJECT, LLC
Active
Organization
ETHOS LEADERSHIP PROJECT, LLC
Active
Other names
The ETHOS Leadership Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA M. GOMES PH.D., PMHNP-BC (CLINICAL DIRECTOR)
(757) 251-6367
Entity
Organization
Contact information
Practice address
1322 LASALLE AVE, SUITE A, HAMPTON, VA 23669-3810
(757) 251-6367
Mailing address
1322 LASALLE AVE, SUITE A, HAMPTON, VA 23669-3810
(757) 251-6367
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024170504
VA
Other
Enumeration date
10/09/2013
Last updated
10/24/2013
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