| NPI | 1639771918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL K. BRADSHAW M.D. 304-551-3885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-11-18 |