| NPI | 1700095882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMIE LYNNE SMITH Member Manager Psychologist 304-425-3327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |