| NPI | 1609624428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-07 |