| NPI | 1326185745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA HEARN Office Manager 757-827-9650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810000978) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |