| NPI | 1790038602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE HERMANSON Manager Of Clinical Services 757-622-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701004678) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |