Individual
DR. THOMAS ODELL DUVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LMHC, NCC
Contact information
Practice address
201 FCI LN, GLENVILLE, WV 26351-9500
(304) 626-2500
(304) 626-2604
Mailing address
PO BOX 5000, GLENVILLE, WV 26351-5000
(304) 626-2500
(304) 626-2604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8470
FL
101YP2500X
Professional Counselor
LPC005142
GA
103TC0700X
Clinical Psychologist
Primary
PY9866
FL
Other
Enumeration date
09/26/2005
Last updated
03/13/2018
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