| NPI | 1164635132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SPEED Family Therapy Supervisor 757-838-8520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701003898) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717001103) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |