| NPI | 1710576343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELISHA NELSON Licensed Clinical Psychologist 804-592-0491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-11-17 |