| NPI | 1902054935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA MAY Assistant Director 804-897-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0119000956) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: VA 2202005085) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2022-01-07 |