| NPI | 1326154634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD CAPAGE President 304-599-1914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 112) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WV 507) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-05-01 |