| NPI | 1811100597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY ENGELLAND WILSON Owner/Psychologist 304-302-2467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist (Licence: WV 752) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-11-09 |