Individual
MARY KATHERINE LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
908 SCARBRO ROAD, SCARBRO, WV 25917
(304) 574-2905
(304) 465-5486
Mailing address
P O BOX 337, 908 SCARBRO ROAD, SCARBRO, WV 25917
(304) 574-2905
(304) 465-1518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111436
TX
1041C0700X
Clinical Social Worker
DP00940388
WV
Other
Enumeration date
05/28/2015
Last updated
11/20/2023
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