| NPI | 1013206200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J TEAGUE Director 703-777-2209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701001459) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |