| NPI | 1215474614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA SHAFFER Licensed Clinical Psychologist 804-873-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810005414) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005414) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |