| NPI | 1962722538 |
|---|---|
| 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 |