| NPI | 1982776902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE B TRICE President 757-593-6792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0101230611) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 05092005) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2008-06-07 |