Individual
JERALDINE YESUDHAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 N GEORGE ST STE 200, CHARLES TOWN, WV 25414-1574
(681) 252-1632
Mailing address
148 KISKADEE DR, BUNKER HILL, WV 25413-8602
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WV
Other
Enumeration date
10/23/2023
Last updated
04/13/2026
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