Organization
21 VETS INCORPORATED
Active
Organization
21 VETS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J PIPPIN (PRESIDENT)
(703) 309-7417
Entity
Organization
Contact information
Practice address
4908 FAUNA DR, MELBOURNE, FL 32934-7847
(703) 309-7417
Mailing address
4908 FAUNA DR, MELBOURNE, FL 32934-7847
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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