| NPI | 1326428129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA WALKER Credentialing Manager 757-232-8769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701001988) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-11-09 |