| NPI | 1073077368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA RUUSKANEN Owner 540-412-8275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-01-30 |