Individual
NICOLENE CAVENDISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
1137 VAN VOORHIS RD, SUITE 28, MORGANTOWN, WV 26505-3453
(304) 598-2971
(304) 598-2975
Mailing address
1137 VAN VOORHIS RD, SUITE 28, MORGANTOWN, WV 26505-3453
(304) 598-2971
(304) 598-2975
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
659
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164951000
—
WV
Enumeration date
07/15/2006
Last updated
11/14/2007
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