| NPI | 1184948655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA SIMMONS Clinical Director 757-626-0332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810004002) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2010-03-26 |