| NPI | 1003416397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA FOWLER Owner/Therapist 304-491-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2022-05-20 |