NPI | 1932816048 |
---|---|
Doing Business As | STRANGE FRUIT PSYCHOTHERAPY |
Entity Type | Organization |
Authorized Contact | SHERVONNE EVETTE BANKS Licensed Clinical Social Worker 757-240-7928 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2022-10-31 |
Last Update Date | 2022-10-31 |