Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 9074 | MA |
N | 103T00000X | Psychologist | 9074 | MA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 9074 | MA |
Y | 103G00000X | Clinical Psychologist | 9074 | MA |
Y | 103TC0700X | Clinical Psychologist | 9074 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 9074 | MA |
N | 103TF0000X | Family Psychologist | 9074 | MA |
NPI | 1023111523 |
---|---|
Provider Name | Dr. Molly Ober Fechter-Leggett |
First Address | Morgantown, WV 26505 |
Second Address | Morgantown, WV 26505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 12/01/2021 |