| NPI | 1053874370 |
|---|---|
| Doing Business As | 108 COUNSELING , LLC |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MCNAMARA Credentialing Manager 804-221-2042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-04-12 |