| NPI | 1457171563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY ANN KRUK-BORISOV Owner / Manager 757-589-3498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 221700000X Art Therapist |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2025-03-27 |