| NPI | 1659050136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENISHA REESE Licensed Clinical Social Worker 757-408-9727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |