| NPI | 1922041136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MCFADDEN President 304-232-7232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 313) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 1683) |
| 101Y00000X Counselor (Licence: WV 1697) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-11-26 |