| NPI | 1114206778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CORSO MASOURAS Business Director/Owner 804-310-5351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904006510) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |