| NPI | 1437688546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN A VAN BRUNT Treasurer 540-698-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-21 |