| NPI | 1386631786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MCCLURE GREEN Owner 304-622-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2022-07-21 |