| NPI | 1467271031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LARSON Owner/Provider 703-431-7055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-10-23 |