| NPI | 1114403854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NICOLE MCCANTS Administrative Manager 757-223-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |