| NPI | 1538257795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDOLPH FLORA President 276-628-5752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904002186) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0812000007-SEX OFFEN) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-08-08 |