| NPI | 1033839220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVORY MELANIE MCMILLIAN Owner 703-615-6915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |