| NPI | 1083080410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE C COOPER Speech Language Pathologist 757-927-3162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: VA 2202006657) |
| Additional Taxonomies | 251E00000X Home Health (Licence: VA 2202006657) |
| 252Y00000X Early Intervention Provider Agency (Licence: VA 2202006657) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |