| NPI | 1962546622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE FRANK MASTERS Counselor 304-256-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WV 1622) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-06-04 |