| NPI | 1265926893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ELIZABETH CONNELLY Incorporator, Stockholder 703-477-4969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NC 5050) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |