| NPI | 1982090882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M STARLING Office Manager 757-499-1694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810001135) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-08-09 |