| NPI | 1972116432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WADDELL Licensed Clinical Social Worker 757-714-4846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2023-11-21 |