| NPI | 1023996105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-26 |