| NPI | 1659935112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATESHA MCINTOSH Licensed Clinical Socia Worker//Own 804-677-6958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2022-06-14 |