| NPI | 1194820118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA GANTT Executive Director 304-291-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: PA PC001898) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WV DP00939059) |
| 1041C0700X Social Worker Clinical (Licence: WV DP00942623) | |
| 221700000X Art Therapist (Licence: 79001) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |