| NPI | 1902138100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDYCE CONNER Owner/Operator 804-502-9847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701004235) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |