| NPI | 1073751293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA HARDESTY Certified Behavior Analyst 804-519-1360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: 1062931) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-01-26 |