Individual
AMY M CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3375 US RT 60 E, HUNTINGTON, WV 25705-0069
(304) 525-7851
(304) 586-0671
Mailing address
P.O. BOX 299, 3389 WINFIELD RD, WINFIELD, WV 25213
(304) 525-7851
(304) 586-0671
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2138
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
Enumeration date
07/29/2014
Last updated
07/29/2014
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