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Individual

MS. BRENDA LEA TEBAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
1200 STEPHENSON AVE STE 400, PARKERSBURG, WV 26101-4889
(304) 699-0506
(304) 422-8850
Mailing address
PO BOX 373, HARRISVILLE, WV 26362-0373
(304) 643-4005
(304) 643-4007

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
WV 878
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810000161
WV
Enumeration date
10/12/2006
Last updated
03/23/2020
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