| NPI | 1295068203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY CARTER GIBSON Member 757-490-7811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810001252) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |