Individual
JULIE CANTERBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N COURT ST, FAYETTEVILLE, WV 25840-1200
(304) 574-4229
Mailing address
100 CHURCH ST, FAYETTEVILLE, WV 25840-1256
(304) 574-4220
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-9153
WV
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
11/26/2021
Last updated
04/04/2023
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