Individual
ELIZABETH WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 ELIZABETH ST, CHARLESTON, WV 25311-2119
(304) 348-7740
Mailing address
501 22ND ST, DUNBAR, WV 25064-1711
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
9002
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010085
—
WV
Enumeration date
09/09/2008
Last updated
09/09/2008
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