Individual
GARY DEAN STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LP
Contact information
Practice address
2121 7TH ST, PARKERSBURG, WV 26101-3803
(304) 485-1721
(304) 485-6710
Mailing address
3518 CADILLAC DR, PARKERSBURG, WV 26104-2114
(304) 485-5578
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
873
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
873
PSYCHOLOGY LICENSE
WV
Enumeration date
02/23/2007
Last updated
07/08/2007
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