| NPI | 1417455031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY LOCKE Manager/Counselor 804-562-6527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0904010195) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |