Individual
TERESA LYNN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDS
Contact information
Practice address
1609 W 3RD AVE, WILLIAMSON, WV 25661-3006
(304) 235-0026
Mailing address
PO BOX 526, GILBERT, WV 25621-0526
(304) 664-3922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LVN-164X00000X
WV
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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