| NPI | 1346098209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LYNN GIBSON Owner 304-690-6428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-07 |