| NPI | 1538348701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA MANN Executive Director 304-255-2043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 757) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |