| NPI | 1043587652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNELLE RENEE' HARRELL Licensed Clinical Social Worker 804-980-5763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904007188) |
| Enumeration Date | 2011-11-27 |
| Last Update Date | 2011-11-27 |