| NPI | 1679019608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD HENRY MCRAE Chief Executive Officer 703-317-7271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004799) |
| Enumeration Date | 2017-01-14 |
| Last Update Date | 2017-01-14 |