| NPI | 1881194074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY BRUSSEAU Owner 540-592-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008320) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-19 |