| NPI | 1073159380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL R TAPP Billing & Credentialing Specialist 434-219-5039 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2021-10-27 |