| NPI | 1699504084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE PETERS Consultant 571-643-6179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-09-05 |