| NPI | 1932291291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL TANT Office Manager 757-461-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 02669) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |