| NPI | 1053151530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE U LARSON Licensed Professional Clinical Coun 703-980-9205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-05-30 |