| NPI | 1639678360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY H. HAUPT Owner 804-258-3765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904002416) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-06-12 |