| NPI | 1790483055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL KITTRELL-JOHNSON Owner 757-632-7107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-07-05 |