Individual
TROY MUMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1085 CANAAN HEIGHTS RD, DAVIS, WV 26260-8007
(304) 851-6643
Mailing address
1085 CANAAN HEIGHTS RD, DAVIS, WV 26260-8007
(304) 851-6643
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-123405
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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