| NPI | 1386089944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE L COSTIGAN Owner 757-430-3238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904001336) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2013-05-08 |