| NPI | 1588733893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY L WEBER Provider 540-568-1876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: VA 0810001674) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2010-05-14 |