Organization
SQUARE ONE FAMILY NETWORKS CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYME DAWN DODD LSW (OWNER, EXECUTIVE DIRECTOR)
(304) 657-8943
Entity
Organization
Contact information
Practice address
1708 LOCUST AVE STE 201, FAIRMONT, WV 26554-1332
(304) 694-7636
(888) 977-2130
Mailing address
1708 LOCUST AVE STE 201, FAIRMONT, WV 26554-1332
(304) 694-7636
(888) 977-2130
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
AP00944042
WV
252Y00000X
Early Intervention Provider Agency
332608
WV
Other
Enumeration date
09/23/2014
Last updated
10/08/2014
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