| NPI | 1063543528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE COOK Director 757-675-1720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701002189) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |