| NPI | 1851779276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE WINGFIELD Director 757-409-7172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701005771) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904008066) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |