| NPI | 1710183504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA F RAY Owner 304-767-7960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 2117) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2012-05-17 |