NPI | 1962722538 |
---|---|
Doing Business As | LAUREL MOUNTAIN |
Entity Type | Organization |
Authorized Contact | LAWRENCE JIMMIE RICHMOND Owner 304-952-1193 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 965) |
Enumeration Date | 2010-06-07 |
Last Update Date | 2010-06-07 |