| NPI | 1881872505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORY FOX DIERKER Owner 703-998-5606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810002996) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2009-12-16 |