NPI | 1871043539 |
---|---|
Entity Type | Organization |
Authorized Contact | ANISSA HOWERTON Counselor 434-709-7167 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006649) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-15-04593) |
Enumeration Date | 2016-10-06 |
Last Update Date | 2017-01-30 |