| NPI | 1912744301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN POOLE Counselor 703-608-1457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-07-11 |