Individual
DEBORAH NOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2869 SENECA TRL S, PETERSTOWN, WV 24963-5037
(304) 425-6110
(304) 487-6199
Mailing address
PO BOX 590, UNION, WV 24983-0590
(304) 425-6110
(304) 487-6199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
641
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721196
BCBS
WV
05
—
0164458001
—
WV
Enumeration date
10/11/2005
Last updated
01/29/2025
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