Individual
KRISTINA M SUPTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 N EISENHOWER DR, BECKLEY, WV 25801-4141
(304) 929-0786
(304) 929-2278
Mailing address
330 N EISENHOWER DR, BECKLEY, WV 25801-4141
(304) 929-0786
(304) 929-2278
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AP00940862
WV
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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