Individual
MS. TAMARA DOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 MOTOKA DR APT 1, NEWPORT NEWS, VA 23602-4053
(757) 768-5876
Mailing address
1000 LITTON LN # F, SUFFOLK, VA 23434-8081
(757) 768-5876
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
23-036-099
VA
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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