| NPI | 1619787983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SIBOLD ASHBY Counselor 540-421-0992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-01-09 |