| NPI | 1255549861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM W CLARK Director 703-506-8378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0810002215) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |