| NPI | 1407150220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE MARIE THARP Licensed Psychologist 304-890-5478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 1010) |
| Enumeration Date | 2011-01-09 |
| Last Update Date | 2016-08-04 |