| NPI | 1922527514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI M BOSTIC Owner 703-283-9083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904004116) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2018-09-13 |