Individual
MS. EUGENIE PROVOSTY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
16 LEON SULLIVAN WAY, SUITE 300, CHARLESTON, WV 25301-2402
(304) 346-9689
Mailing address
16 LEON SULLIVAN WAY, CHARLESTON, WV 25301-2402
(304) 346-9689
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
DP00939976
WV
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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