| Organization Name: | 7TH AVE CLINIC |
| NPI Number: | 1932288107 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LYNN M SANDERS (OWNER) |
| Mailing Address: | 623 Temple St Hinton |
| State: | WV US |
| Postal Code: | 25951 |
| Phone Number: | 3046731913 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 06/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 889 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |