| NPI | 1922213727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CHRISITNE OHARA Clinical Director 757-620-6559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002817) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |