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