| NPI | 1528091063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE FOORE Credentialing Coordinator 434-392-7049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-11-09 |