Organization
HOLISTIC PSYCHIATRY AND MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS CUDJOE OWUSU PMHNP, FNP (OWNER)
(571) 315-3313
Entity
Organization
Contact information
Practice address
556 GARRISONVILLE RD STE 210, STAFFORD, VA 22554-7819
(301) 917-5808
(571) 774-4123
Mailing address
214 DETERMINATION DR, STAFFORD, VA 22554-3366
(301) 917-5808
(571) 774-4123
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/12/2021
Last updated
12/05/2023
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