| NPI | 1669171393 |
|---|---|
| Other Name | GROUP PRACTICE - BEHAVIORAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | GROVER GLENDON KERNS VP Of Finance 304-260-1443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-03-02 |