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Provider Information for 1700629565


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FRIEND IN BOX INC FIAB

Other Names:  
Other Name: 
F.I.A.B.

Organization Subpart: NO

NPI: 1700629565
Last Updated: 2025-02-25
Certification Date: 2025-02-25

Details

NameValue
NPI1700629565
Enumeration Date2024-06-18
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Mrs. SHERIE REGINA MAWUSI
Title: Owner
Phone: 7573158039
Mailing Address 15 RESEARCH DR STE A
HAMPTON, VA 23666-1324
United States

Phone: 757-315-8039 | Fax:757-902-1629
 
Primary Practice Address 15 RESEARCH DR STE A
HAMPTON, VA 23666-1324
United States

Phone: 757-315-8039 | Fax:757-902-1629
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 193200000X - Multi-Specialty Group
1041C0700X - Social Worker - Clinical