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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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