| NPI | 1750761276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MARILYN KREISS Lcsw 703-524-6380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904000056) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |