| NPI | 1770459869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MARIE KING WIGGINS Member 757-771-5088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-15 |