| NPI | 1619040805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DAVID MOSES Director 304-599-5751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2010-06-03 |