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Individual

CAMARITA BIH TITANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6677 RICHMOND HWY, ALEXANDRIA, VA 22306-6647
(703) 535-5568
Mailing address
16638 RESERVOIR LOOP, DUMFRIES, VA 22026-6808
(703) 649-8142

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0017146612
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
T61334978
VA
Enumeration date
01/02/2020
Last updated
01/02/2020
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