# THE CHANGING TIDE BODY MIND & SPIRIT PC DBA I CHOOSE LIFE INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE CHANGING TIDE BODY, MIND & SPIRIT P.C.
- **Other names:** I Choose Life Inc.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962196683
- **Legal business name:** THE CHANGING TIDE BODY, MIND & SPIRIT P.C.
- **Authorized official:** MRS. DEBRA MOORE ZIEROW PMHNP-BC (OWNER)
- **Authorized official phone:** (804) 725-3041

## Contact information

- **Practice address:** 75 MAIN STREET, STE E, MATHEWS, VA 23109
- **Practice address phone:** (804) 725-3041
- **Practice address fax:** (804) 725-3510
- **Mailing address:** PO BOX 327, MATHEWS, VA 23109-0327
- **Mailing address phone:** (804) 725-3041
- **Mailing address fax:** (804) 725-3510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2023
- **Last updated:** 06/20/2023