| NPI | 1215104856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY HEATHER SHAHEEN Licensed Clinical Social Worker 804-257-9628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0904006763) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |