| NPI | 1740321769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L HAWLEY Clinical Psychologist 703-850-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: VA 0810001126) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810001126) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810001126) | |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2020-08-22 |