| NPI | 1427392174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE WAYSON Deputy Director 4105-853-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: VA 2202006832) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |