| NPI | 1609657766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY COBB CFO 740-751-4531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2023-10-13 |
| Last Update Date | 2023-10-13 |