| NPI | 1518054733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WOODROW FULLER Cep 804-967-0486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904000574) |
| Enumeration Date | 2006-10-08 |
| Last Update Date | 2008-05-07 |