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Individual

KEVIN S PERDUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PRSS

Contact information

Practice address
2333 MACCORKLE AVE, SAINT ALBANS, WV 25177-2073
(304) 360-2225
Mailing address
2333 MACCORKLE AVE, SAINT ALBANS, WV 25177-2073
(304) 360-2225

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.169622
OH
175T00000X
Peer Specialist
Primary

Other

Enumeration date
03/21/2019
Last updated
05/06/2024
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