| NPI | 1790130508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FRANKLIN Director 304-728-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 521) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2024-09-11 |