| NPI | 1972989994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NETA CAROL MAYNARD Single Member/Owner 304-236-3517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV DP00943710) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2016-05-25 |