NPI | 1790830479 |
---|---|
Entity Type | Organization |
Authorized Contact | PHYLLIS A BERG President 804-285-4121 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 810001051) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 904003375) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2020-08-22 |