| NPI | 1487490876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA MICHELLE DILLARD Owner 571-443-8237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |