| NPI | 1265798102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE L ANDERSON Owner 540-419-0229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0701003974) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |