| NPI | 1073681755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE P JENNINGS Clinical Psychologist Owner 304-267-1663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-06-20 |