| NPI | 1821657941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEEL A PATEL CEO 304-615-8102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2022-09-15 |