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Organization
INTERCESSORY COUNSELING AND CONSULTING OUTREACH INC
Active
Organization
INTERCESSORY COUNSELING AND CONSULTING OUTREACH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK GIBSON (PROVIDER)
(304) 415-5715
Entity
Organization
Contact information
Practice address
1113B JEFFERSON RD, S CHARLESTON, WV 25309-9780
(304) 415-5715
Mailing address
1113B JEFFERSON RD, S CHARLESTON, WV 25309-9780
(304) 415-5715
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
NULL
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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