| NPI | 1730046483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA MARINO Director 571-477-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2026-01-06 |
| Last Update Date | 2026-07-13 |