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Individual

DAVEANNA JOELLA MASTERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
912 21ST ST APT B, VIENNA, WV 26105-1318
(810) 252-2494
Mailing address
912 21ST ST APT B, VIENNA, WV 26105-1318
(810) 252-2494

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
189807
OH

Other

Enumeration date
09/09/2024
Last updated
09/09/2024
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