| 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 |