| NPI | 1669839650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIELA G FALLON Owner 757-504-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002992) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |