Organization
DIVERSIFIED ASSESSMENT & THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA KISER GRIFFITH PSY (EXECUTIVE DIRECTOR)
(304) 453-2800
Entity
Organization
Contact information
Practice address
4614 WAVERLY RD, HUNTINGTON, WV 25704-1039
(304) 429-3287
Mailing address
1401 CHESTNUT ST, KENOVA, WV 25530-1235
(304) 453-2800
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SLP-1339
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3910000370
—
WV
Enumeration date
02/24/2012
Last updated
08/30/2019
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