| NPI | 1740081223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI M GRIMM Authorized Official 703-994-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 103T00000X Psychologist | |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-10-17 |