| NPI | 1043596497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN E FELLOWS Owner 571-296-0583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701004609) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |