| NPI | 1932650520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C BERRY Sole Mbr 757-490-3996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904007337) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |