| NPI | 1124888656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMARILYS GALLOZA CARRERO Clinical Psychologist 757-803-6399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |