Individual
AMANDA JO MONGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
342 BEVERLY DR, PETERSBURG, WV 26847-9760
(304) 703-7492
Mailing address
342 BEVERLY DR, PETERSBURG, WV 26847-9760
(304) 703-7492
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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