| NPI | 1851799324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE E. BOOTH Psychotherapist 571-477-0096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904006947) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |