| NPI | 1295875375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMAINE H. JOHNSON Executive Director 703-425-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251S00000X (Licence: VA 24203001) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2012-08-02 |