Individual
DARLENE M SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 220, BRIDGEPORT, WV 26330-0220
(304) 933-3073
Mailing address
PO BOX 220, BRIDGEPORT, WV 26330-0220
(304) 933-3073
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
12/13/2024
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