| NPI | 1699705459 |
|---|---|
| Other Name | PHILICIA JEFFERSON WILSON |
| Entity Type | Organization |
| Authorized Contact | PHILICIA JEFFERSON Director 540-710-0520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 831) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2008-06-19 |