Organization
ETHOS LEADERSHIP PROJECT, LLC
Active
Other names
The ETHOS Leadership Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA M. GOMES PH.D., PMHNP-BC (CLINICAL DIRECTOR)
(757) 251-6367
Entity
Organization
Contact information
Practice address
1322 LASALLE AVE, SUITE A, HAMPTON, VA 23669-3810
(757) 251-6367
Mailing address
1322 LASALLE AVE, SUITE A, HAMPTON, VA 23669-3810
(757) 251-6367
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024170504
VA
Other
Enumeration date
10/09/2013
Last updated
10/24/2013
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