| NPI | 1275031726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL C REID Lead Psychologist 757-344-0857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004560) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-01-30 |