Organization
THE CHANGING TIDE BODY MIND & SPIRIT PC DBA I CHOOSE LIFE INC.
Active
Parent organization
THE CHANGING TIDE BODY, MIND & SPIRIT P.C.
Other names
I Choose Life Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CHANGING TIDE BODY, MIND & SPIRIT P.C.
Authorized official
MRS. DEBRA MOORE ZIEROW PMHNP-BC (OWNER)
(804) 725-3041
Entity
Organization
Contact information
Practice address
75 MAIN STREET, STE E, MATHEWS, VA 23109
(804) 725-3041
(804) 725-3510
Mailing address
PO BOX 327, MATHEWS, VA 23109-0327
(804) 725-3041
(804) 725-3510
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019115759
—
VA
01
—
VVU978C639
MEDICARE
VA
Enumeration date
06/06/2023
Last updated
06/20/2023
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