| NPI | 1174729990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOSEPH DELUCA Managing Member 304-626-3541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 1540) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2008-01-01 |