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Individual

MR. ANDREW JOSEPH WOOLWINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
EDS

Contact information

Practice address
1201 N 15TH ST, CLARKSBURG, WV 26301-1989
(304) 624-6554
(304) 624-5223
Mailing address
239 COURT AVE, WESTON, WV 26452-2099
(304) 624-6554
(304) 624-5223

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
9869
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810021612
WV
Enumeration date
10/14/2011
Last updated
11/09/2011
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