Individual
BRENDA WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66 TORIE LANE, CARKSBURG, WV 26301
(304) 838-1463
Mailing address
60 HANOVER ST, CLARKSBURG, WV 26301-6087
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/30/2025
Last updated
09/30/2025
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