| NPI | 1437647971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA LEE HOGINS Owner 757-965-5624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005216) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |