| NPI | 1093420630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA B STUKES Owner 757-955-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 226000000X Recreational Therapist Assistant |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-01-18 |