NPI | 1104165216 |
---|---|
Entity Type | Organization |
Authorized Contact | DREAMA SHORT Licensed Professional Counselor 304-763-7088 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 1361) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WV 1054) |
Enumeration Date | 2013-02-08 |
Last Update Date | 2013-02-08 |