| NPI | 1285085837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISSI FISHER Business Director/Assistant Directo 304-696-5220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 391) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-24 |