| NPI | 1003456336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTI JO SISK-FANDRICH Owner/Psychologist 540-681-1669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2021-08-19 |