Individual
MR. THOMAS MARK MAMALAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2305 N PARHAM RD STE 3, RICHMOND, VA 23229-3156
(804) 270-1124
Mailing address
2305 N PARHAM RD STE 3, RICHMOND, VA 23229-3156
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024181685
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024181685
VIRGINIA BOARD OF NURSING LICENSE
VA
Enumeration date
06/24/2021
Last updated
06/24/2021
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