| NPI | 1700986080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SUMPOLEC Director 540-548-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701003590) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717001031) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-09-17 |