| NPI | 1669966958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA M MIXON Owner 540-809-8970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008479) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |