| NPI | 1407380926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K HECK Member 434-409-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: VA 0102203941) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |