| NPI | 1780834911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FACCIOLA Member/Manager 703-203-7535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904005064) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2018-04-27 |