| NPI | 1356768675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BROWN Clinical COO Rdinator 540-773-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810003713) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: VA 0803000056) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |