| NPI | 1033598982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA SOUKUP Program Therapist 540-953-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717001173) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: VA 953736) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |