| NPI | 1467291906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN ROCHA Owner 757-506-8252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2025-05-01 |