Individual
MARIAM SOPHIA BOUANANE-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
3500 VIRGINIA BEACH BLVD STE 202, VIRGINIA BEACH, VA 23452-4445
(757) 720-1040
(757) 720-1041
Mailing address
3500 VIRGINIA BEACH BLVD STE 202, VIRGINIA BEACH, VA 23452-4445
(757) 720-1040
(757) 720-1041
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024187257
VA
Other
Enumeration date
01/04/2023
Last updated
07/01/2025
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