Individual
MRS. SANDRA BERNADINE VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, NCC
Contact information
Practice address
174 LMAMH CENTER ROAD, LOGAN, WV 25601-0176
(304) 792-7130
(304) 792-7146
Mailing address
300 PROSPERITY LANE, SUITE #204, PO BOX 176, LOGAN, WV 25601-3743
(304) 792-7130
(304) 896-5183
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2364
WV
Other
Enumeration date
09/25/2018
Last updated
02/08/2019
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