| NPI | 1902307069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH A BLACK Owner 434-996-6562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0149851) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |