| NPI | 1316470503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN MARIE RODRIGUEZ ARCHILLA Director, Clinical Psychologist 434-566-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: VA 0810005495) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: VA 0810005495) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810005495) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: VA 0810005495) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |