| NPI | 1629328588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMA HOLTON Credentialing Coordinator 804-643-2287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904000072) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904006062) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904007781) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |