| NPI | 1124275300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGY BURNS Executive Director 304-636-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WV 18352) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |