| NPI | 1790926020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE BERNADETTE HAIRSTON Owner/Provider 804-233-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904006223) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |