Individual
BILLIE JO SIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
586 TUNNELTON ST APT A, KINGWOOD, WV 26537-7083
(304) 282-6257
Mailing address
586 TUNNELTON ST APT A, KINGWOOD, WV 26537-7083
(304) 282-6257
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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