NPI | 1306235783 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDA BOURDON REIN Director 757-345-6428 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004468) |
Additional Taxonomies | 101Y00000X Counselor (Licence: VA 07010005880) |
101Y00000X Counselor (Licence: VA 08701003392) | |
Enumeration Date | 2015-01-22 |
Last Update Date | 2015-01-22 |