| NPI | 1215307558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENINNE MCNEILL Licensed Clinical Psychologist 757-222-0814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004873) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2016-05-07 |