| NPI | 1104044528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE M STEVENS President, Psychologist 757-486-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 90801000970) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2010-09-01 |