| NPI | 1699286930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADDRIANNE COOMBS Director Of Business Development 571-271-3250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024164470) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0024164470) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-11-03 |