| NPI | 1366743460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JOSEPH GUALTIERI Director 703-790-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810001429) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |