| NPI | 1003828799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE NEWTON DESHAZO Owner 757-873-1958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701001314) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000318) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |