| NPI | 1104973809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GROOM Owner 304-865-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2024-05-30 |