| NPI | 1801060355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ANN WAITKUS Director 804-526-9885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002551) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000861) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |