| NPI | 1518751957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-09 |