| NPI | 1164701272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN F WARANCH Owner 757-685-7005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810001439) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102006) |
| Enumeration Date | 2011-08-07 |
| Last Update Date | 2011-08-07 |