Organization
UNITY OUTREACH MINISTRIES OF AMERICA, LLC
Active
Organization
UNITY OUTREACH MINISTRIES OF AMERICA, LLC
Active
Other names
Magnolia Angels
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY DENICE COWARD (ADMINISTRATOR/ OWNER)
(757) 581-3897
Entity
Organization
Contact information
Practice address
1122 LONDON BLVD, PORTSMOUTH, VA 23704-2246
(757) 581-3897
Mailing address
1122 LONDON BLVD, PORTSMOUTH, VA 23704-2246
(757) 581-3897
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001748
VA
163WP0808X
Psychiatric/Mental Health Registered Nurse
0001169953
VA
Other
Enumeration date
07/21/2015
Last updated
07/21/2015
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