| NPI | 1932655669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE TWAALFHOVEN Clinical Mental Health Counselor 434-466-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD LGP5845) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |