Individual
NIKITA DELOATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 CITY PARK AVE, PORTSMOUTH, VA 23701-2227
(757) 300-6828
Mailing address
1500 CITY PARK AVE, PORTSMOUTH, VA 23701-2227
(757) 300-6828
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
11873
VA
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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