| NPI | 1639463995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY DIANNE MUSCARI Manager 304-925-0831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WV 1238) |
| Enumeration Date | 2011-06-04 |
| Last Update Date | 2011-06-04 |