Individual
TAMIKA IRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4204 POINTERS TRL, CHESAPEAKE, VA 23321-3245
(757) 839-6956
Mailing address
4204 POINTERS TRL, CHESAPEAKE, VA 23321-3245
(757) 839-6956
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
3530
VA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
3530
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-1305799
—
VA
Enumeration date
06/03/2022
Last updated
07/11/2022
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