Individual
DIANA BOUTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, PMHNP-BC
Contact information
Practice address
7489 RIGHT FLANK RD, MECHANICSVILLE, VA 23116-3845
(804) 398-8401
Mailing address
3137 WELSH CIR, RICHMOND, VA 23223-2180
(804) 712-3547
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024176352
VA
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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