| NPI | 1720143555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CAROL BAISDEN Owner Therapist 304-235-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 403) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV 538) |
| 1041C0700X Social Worker, Clinical (Licence: WV CP00452669) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2015-08-03 |