| NPI | 1033286794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LINN MORTELLARO Clinical Director 540-772-8043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701001496) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-05-08 |