| NPI | 1932290624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T. BURKE Managing Partner 804-744-9652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810000953) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0015000796) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-01-11 |