| NPI | 1548792112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISHA OTERO Licensed Professional Counselor 804-536-0780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701006962) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2017-04-01 |