| NPI | 1467671446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE M ROSS Owner 757-623-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810001655) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |