| NPI | 1205355898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YASIM S CLARK Licensed Mental Health Clinician 804-277-7761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701006598) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2022-07-21 |