Individual
JORDEN WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3135 16TH STREET RD STE 12, HUNTINGTON, WV 25701-5247
(681) 404-6869
Mailing address
3902 BRANDYWINE DR, CATLETTSBURG, KY 41129-9674
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00945786
WV
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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