| NPI | 1235619388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA N DENNIS Owner 757-271-9030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0904007980) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |