| NPI | 1801361027 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LAUREN SHEEHAN Administrator 703-841-5455  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2018-10-04 | 
| Last Update Date | 2018-10-04 |