| NPI | 1962746370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESS GALLARO Office Manager 540-433-2858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004403) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004423) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |