| NPI | 1154207157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES GIBBS Admin/Credentialing Specialist 757-354-4517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-08-14 |