| NPI | 1336686856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN W WILKES Clinical Psychologist 540-421-6660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 10086571-2501) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |