Individual
LACEE DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 ELIZABETH ST, CHARLESTON, WV 25311-2197
(304) 348-7740
Mailing address
200 ELIZABETH ST, CHARLESTON, WV 25311-2197
(304) 348-7740
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
Y5H145900289
WV
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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