| NPI | 1093202541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANA WEAVER President 757-578-2985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904007147) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701006630) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2023-09-12 |