| NPI | 1215181300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN MILLER Credentialing Specialist 540-217-6461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 6635) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2025-02-11 |