NPI | 1912433715 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE GORE Therapist/Owner 757-602-0111 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904007634) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2017-05-11 |