| NPI | 1407679251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CRAYTON Clinical Supervisor/Clinician 757-529-1575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-10-31 |
| Last Update Date | 2025-01-19 |