| NPI | 1699424291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRANESE MORGAN Owner/Operator 757-809-6078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-03-21 |