| NPI | 1770296592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CULLEN HARDY Owner 434-770-0230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2022-12-27 |