Organization
DELTONA WELLNESS & PSYCHIATRY CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA BALOUS (PRESIDENT)
(866) 866-7215
Entity
Organization
Contact information
Practice address
2401 E GRAVES AVE STE 19, ORANGE CITY, FL 32763-8582
(866) 866-7215
Mailing address
1618 AMBOY DR, DELTONA, FL 32738-5202
(866) 866-7215
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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