| NPI | 1407168859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY COLLINS BALLINA Licensed Psychologist 304-766-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 737) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |