| NPI | 1497383152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY B. HERTZA Founder/Medical Director 703-346-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103G00000X Clinical Neuropsychologist | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-04-06 |