| NPI | 1710624440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHANTI NEWKIRK Licensed Professional Counselor 757-347-2758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-05-15 |
| Last Update Date | 2022-06-24 |