| NPI | 1447542451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLUVERIUS BANKS Owner 757-869-7559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202002934) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |