| NPI | 1770003311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEKA MALLARD TUCKER Licensed Clinical Psychologist 703-786-5486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004954) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701007049) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2022-07-21 |