| NPI | 1336258250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAY BUXTON Licensed Clinical Psychologist 757-490-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-07-21 |