Individual
LEX DE GRUYL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR PSYCHOLO
Contact information
Practice address
240 WINDY RUN RD, LITTLE BIRCH, WV 26629-9502
(304) 765-5919
Mailing address
240 WINDY RUN RD, LITTLE BIRCH, WV 26629-9502
(304) 765-5919
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
21003
WV
101YS0200X
School Counselor
1124
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164362000
—
WV
Enumeration date
12/11/2006
Last updated
09/11/2025
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