| NPI | 1497987101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN M KILGOUR Clinical Psychologist 804-592-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA s297122-6) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2010-12-01 |