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GARY DEAN STOVER MA, LP

Mental Retardation and Developmental Disabilities

Parkersburg, West Virginia

Provider NPI: 1538295829

Provider Information:
 GARY DEAN STOVER MA, LP
Gender: M
Not Sole Proprietor

Practice Location:
2121 7TH ST  PARKERSBURG, WV 26101 US
Tel: 304-485-1721  Fax: 304-485-6710

Business Mailing Address:
3518 CADILLAC DR  PARKERSBURG, WV 26104 US
Tel: 304-485-5578  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TM1800XBehavioral Health & Social Service Providers
Psychologist
Mental Retardation & Developmental Disabilities
WV873

Other Provider Identifiers:

IssuerNumberStateType
PSYCHOLOGY LICENSE873WV01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







DEVELOPMENTAL DISABILITIES JOBS WV - Page 1

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