| NPI | 1508518127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA NICHOLE BETHEL Mental Health Provider/Owner 757-816-2722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |