Organization
AWAKENING OF THE SOUL PSYCHOTHERAPY SERVICES, LLC
Active
Other names
Awakening of the Soul Psychotherapy Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WILMARIE VEGA- MATOS LCSW (OWNER)
(787) 203-1535
Entity
Organization
Contact information
Practice address
1005 LOUISA AVE, PORTSMOUTH, VA 23707-2931
(787) 203-1535
Mailing address
1005 LOUISA AVE, PORTSMOUTH, VA 23707-2931
(787) 203-1535
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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