| NPI | 1841622537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN NIEZGODA Managing Member 757-291-5195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005086) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 701005413) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |