Individual
KITTY BLACKHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
347 CAMPBELLS CREEK DR, CHARLESTON, WV 25306-6805
(304) 415-2104
Mailing address
347 CAMPBELLS CREEK DR, CHARLESTON, WV 25306-6805
(304) 415-2104
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/12/2024
Last updated
12/11/2024
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