| NPI | 1134642754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD W LANKFORD Owner/Therapist 276-415-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006875) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-07-25 |