| NPI | 1104527332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA C SILLS-TAILOR Owner 757-724-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-11-28 |