Individual
SHANE PATRICK LIGHTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1249 MEADOW LN, MILTON, WV 25541-8577
(304) 840-8686
Mailing address
1596 WASHINTON BLVD, HUNTINGTON, WV 25701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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