| NPI | 1699271122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MARIE GREEN Owner 434-414-1855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701007474) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-04-04 |