| NPI | 1548786692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELINA PARKER Vice President 757-809-5376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2019-05-06 |