Organization
PARADOX MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE DAVILA PMHNP-BC (OWNER)
(703) 932-9964
Entity
Organization
Contact information
Practice address
12872 HARBOR DR, WOODBRIDGE, VA 22192-2921
(571) 946-5512
(571) 376-6506
Mailing address
6857 JOCKEY CLUB LN, HAYMARKET, VA 20169-2979
(703) 932-9964
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
07/09/2024
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