| NPI | 1912540576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC KEITH WOOD Authorized Official 804-307-8964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-10-25 |