| NPI | 1619081742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD GOLDENBERG Director 757-626-3733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: VA 0101046618) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-01-09 |