| NPI | 1174768212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |