| NPI | 1891169819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MISCO Sole Member 540-776-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904005798) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |