Individual
JASON GINEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADC
Contact information
Practice address
55 N BOLTON ST, SUITE 100, ROMNEY, WV 26757-1635
(304) 359-2245
(304) 359-2259
Mailing address
55 N BOLTON ST, SUITE 100, ROMNEY, WV 26757-1635
(304) 359-2245
(304) 359-2259
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
99-118
WV
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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