| NPI | 1740427418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA THIVIERGE Reimbursement Supervisor 757-819-6219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701004407) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717001184) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-01-16 |