| NPI | 1770060717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYNE RUSHIN Administrator 703-593-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |