| NPI | 1255773040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENETTA MARCELLINA ST. JULIAN Speech Language Pathologist 804-562-1758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: VA 2202005827) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: VA 2202006255) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |