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Organization

7TH AVE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYNN M SANDERS MA (OWNER)
(304) 673-1913
Entity
Organization

Contact information

Practice address
623 TEMPLE ST, HINTON, WV 25951
(304) 673-1913
Mailing address
HC 74 BOX 284, HINTON, WV 25951-9121
(394) 673-1913
(304) 466-1676

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
889
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
WV
Enumeration date
11/06/2006
Last updated
06/13/2008
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