| NPI | 1942989264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLASIN ALLEN License Professional Counselor 757-977-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2024-01-09 |