Individual
BRIAN ADAM MITNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11713 JEFFERSON AVE, NEWPORT NEWS, VA 23606-2400
(469) 865-9040
Mailing address
2002 EGGER CIR, HAMPTON, VA 23663-1110
(469) 865-9040
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704017800
VA
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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