| NPI | 1194531764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS EXUM Owner 804-215-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TH0004X Psychologist, Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 133V00000X Dietitian, Registered | |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-12 |