| NPI | 1750015798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY STINNETT Credentialing Specialist 434-509-0460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-14 |