| NPI | 1588334981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY THEODORE Therapist/Owner 571-403-1283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |