| NPI | 1801255880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIO LONG Owner 703-479-5610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004025) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: VA 0810004025) |
| 103TH0004X Psychologist, Health (Licence: VA 0810004025) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: VA 0810004025) | |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-03-21 |