| NPI | 1457413098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERCEDES WILSON DALLAS Clinical Psychologist 703-838-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0810001425) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |