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Individual

NOLA GLENORA GUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
205 CENTER ST, PRINCETON, WV 24740-2931
(304) 431-2424
(304) 431-3443
Mailing address
205 CENTER ST, PRINCETON, WV 24740-2931
(304) 431-2424
(304) 431-3443

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CP00943432
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0023441001
WV
Enumeration date
04/02/2014
Last updated
07/21/2022
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