| NPI | 1508149907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN FISHER Licensed Clinical Psychologist 703-330-3105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0810003919) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |