| NPI | 1790347110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MARY FUSS REALI Clinical Psychologist 757-285-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |