| NPI | 1043017353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE DELORES JOHNSON Owner 804-255-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-02-26 |