| NPI | 1467104844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAILYN RAE SLADE Licensed Clinical Social Worker 703-220-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-01-26 |