| NPI | 1568224665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA WASHINGTON Owner 757-344-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-02-09 |