| NPI | 1164058111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY SMITH Employee 540-219-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |