| NPI | 1699533828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE EVADNE TATUM Owner/Clinical Director 804-931-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2024-03-12 |