| NPI | 1265921803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JANE GAUTHIER Owner 757-788-6260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005954) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |