| NPI | 1326102799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY KOCH Director 703-330-9933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0904002397) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |