| NPI | 1770988354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE T SHIRAEV Psychotherapist/Sole Proprietor 540-808-5343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60091324) |
| Enumeration Date | 2014-10-25 |
| Last Update Date | 2014-10-25 |