| NPI | 1740521871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESTER SARGENT Licensed Psychologist 304-855-5886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 799) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WV 799) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WV 799) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WV 799) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: WV 799) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: WV 799) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: WV 799) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2013-03-14 |