| NPI | 1679830541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEISHA SPARROW Credentialing Authorization Spec 757-244-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2021-02-08 |