Individual
STACEY DUNLAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 BASS WOOD DR, RIDGELEY, WV 26753-7716
(304) 813-4657
Mailing address
104 BASS WOOD DR, RIDGELEY, WV 26753-7716
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/12/2021
Last updated
02/12/2021
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