Individual
KIRSTEN HEMDAHL COIT FETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
971 HARRISON AVE, YOUTH HEALTH SERVICE INC, ELKINS, WV 26241
(304) 636-9450
(304) 636-7057
Mailing address
971 HARRISON AVE, YOUTH HEALTH SERVICE INC, ELKINS, WV 26241
(304) 636-9450
(304) 636-7057
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LPC1772
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023399001
—
WV
Enumeration date
05/30/2007
Last updated
07/08/2007
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