| NPI | 1932821287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WOLFE Billing Coordinator 434-391-4487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2022-09-20 |